Laserfiche WebLink
PAYMENT <br /> RECEIVED <br /> AUG 0 7 1992 <br /> SAN JOAQ'J!N C0(:NTY <br /> PUBLIC HEALTH SER'd:i;ES <br /> SAN JOAQUIN COUNTY PUBLIC NEALYN SERVICES ENVIRONMENIALHEALTH D�YISION <br /> ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK PROGRAM - FEE WORKSHEET <br /> FACILITY SITE NAME FACILITY CONTACT NAME JACK DE WITT <br /> F MARTHA WEEKS WESTERN METER SERVICE, INC. 948-6124 <br /> A <br /> 1 FACILITY ADDRESS SITE PHONE ! with AREA CODE(209)369-3286 <br /> L 906 S. PLEASANT AVE, <br /> T CITY STATE 21P CODE at SIof TE K$ 1 <br /> Y CA 95240 <br /> A APPLICANT/BILLING NAME APPLICANT CONTACT NAME . <br /> P WESTERN METER SERVICE, INC. JACK DE MITT <br /> P <br /> L APPLICANT PHONE If y(T(1 AREA CODE <br /> C MAILING ADDRESS 2735 TEEPEE DR 209)948-6124 <br /> A si�TE IP E TYPE of APPLICATION <br /> N CITY �,� `.5--r-vim �C�q,✓ tiA ?20� CLOSURE, INSTALLATION, etc.REMOVAL <br /> T <br /> TOTAL <br /> A 1986 1987 1988 1989 1990 <br /> T ANNUAL FACILITY NEE (Prior to January 1, 1991) • $100.00 00 /p o BUD ZU /100 $ <br /> I <br /> E TANK FEE • 150.00/TANK (prior to Janwry 1,1991) 5170/TANK (e}ter January 1, 1991) <br /> F $ Tanks • 1986 1987 1988 1989 1990 1991 1992 7993 1991 1995 7996 <br /> A (multiply t'TT fee for S <br /> U .avD <br /> each year app tcable) <br /> L STATE AN(CHARGE • $56.00 each TANK (Due every 5 years) Sea Callfornta H $ 9 Code, Section 25287 <br /> T M Tanks__ x $56.00 1986 through 1990 1991 through 1996 <br /> Y (enter anglnt and year) $ <br /> PERMANENT CLOSURE (Removal or Authorized Closure-in-Plaoa) TARL I.D. !(U <br /> CcLOS11RE FEE m $53.00 per ham (3 hours minimum per TANK) / TANK($)_ X $159.00 $ <br /> 0 <br /> U TEMPORARY CLOSURE (A one-time Permit, for review/inspections) TAI[ I.D. !(t) <br /> E TEMPORARY CLOSURE FEE • $150.00 each TANK ! TANK(U __ X (150.00 • $ <br /> P1 PLAN CHECK (Install. Plan Review t Construction Inspections) I TANK I.D. !($) <br /> L <br /> N PLAN CHECK FEE - $53.00 per hour (8 ho $ minimum per Fscility) • !424.00 minimum <br /> ur $ <br /> R REPAIR FEE (workplan review L Construction inspections) TANK I.D. !(s) <br /> P TANK REPAIR FEE + $53.00 per hour (3 hour$ Mini TANK) 1 TANK($) __ X $159.00 • S <br /> A <br /> R PIPING REPAIR FEE • $53.00 per hour (3 hour mini" par faeility • $159.00) $ <br /> M TRANSFER FEE • $20.00 UNAUT NORI2ED RELEASE EVALUATION • $53.00/hr $ <br /> 1 <br /> • $53.DO/hr S <br /> C CONSULTATIOI FEE • $53.00/hr SAIIPLINO 1NSPECTIOI FEE - <br /> TOTAL DUE $ =0 - <br /> 2-0 <br /> 2-0 3 77 <br /> EH 23 032 (Revised 4/8/91) Page 11 <br />