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ENVIRONNENIAL NEALtO DIVISION
<br /> RORCIIND STORAGE TAW PROGRAM • FEE t" Sti
<br /> �AC IIi FY SITE NAME FACILITY CONTACT NAME
<br /> A
<br /> Y _
<br /> S calico_ ,
<br /> I rArltltY ADDRESS SITE 1'"It E Ylth AREA CODE
<br /> 1 r
<br /> 1 CITY , STATE 2IO CODE ( stTA
<br /> of NK! �— (,CC.
<br /> ^,t) _-----
<br /> r
<br /> n Apnt ltAwt/p ILL IND NANF APPLICANT CONTACI NAME
<br /> F
<br /> P
<br /> ( •kc _rte - r
<br /> I NAIt 1Nr, ADDRESS APPLICANT ONONE R VI10 AREA CODE
<br /> p CITYAtA E 21P E TYPE of APPLICATION
<br /> T a1n S" �(, c(bSI1RE, INlTALLATtbN, ett.
<br /> _
<br /> ...__
<br /> A
<br /> 1986 I987 19A8 1489 1990 —
<br /> I ANNUAL FACILITY FF.E (prior to January 1, 1991) A !100.06 1
<br /> J—�,—
<br /> F TANK FFF. _ 550.00/TANK (prior to Jonuary 1,1991) - WO/TANK (after January 1, 1991)
<br /> 1 -NInnke- --- Z 1987 1984 1989 1990 1991 1992 (99719461f"Atarty a byCee foryear mppliceb(e)
<br /> 1 CfArF. 1I.MC11WIF - t56.n0 ench TANK (Due every 5 yeera) !I! tallfornle N I. ! Code, settlon 25287
<br /> 1 _. ____.. ._....__.__-
<br /> a T ,A, _ A f56.Dn 1986 through through 1996
<br /> -�� -- � u!h 1990 1991 thr
<br /> w (en.rr !,mmt and year) I —.——
<br /> 47- 57G
<br /> PwmiirNi CLOSURE (Rrmovml or Authorized CtosUre•In-Plae!) TANK I.D. 00)
<br /> C _
<br /> I CL091mF. FEF. = 153.00 per hour 0 hours minimum per TANK) 0 TANK(s)__L_ X tis9.00 • S /�� ,QQ
<br /> II TENrrRARY CLOgMF (A ore-time permit, for review/Ir1lpECtIMY) TANK 1.0. #(a)
<br /> R
<br /> TFNPrOARY CLOSURE FFF = 5150.00 each TANK R TANK(s) X 11150.00 • 5
<br /> P
<br /> P'All McK (Inatall Plan Review R ConStrUet(o0 inlp0tIODS) TANK I.D, A'(s)
<br /> L
<br /> N FLAN CIIPCK FFF - tS3.00 per hour (8 hours mint"" par tiel(lty) IN !626.00 ml"Ift" s
<br /> R RFPAIR FFF. (workpinn review A construction Inspections) TANK I.D. #(a)
<br /> r FANY. RRPAIR rFd x93,00 per hour 0 hours minimWTANK) R LANK(!) It lIS9.08 • s
<br /> R PIPING RFPAIR FEE = 1IS3.00 per hour (3 hour minlmtAA paP TECltlty a !1$9.00) s
<br /> N CnN•IR IAI(CAIS UNAUTNOR12E0 AELEAAE EVALUATION SANPLIMO INSPECt10N T
<br /> I
<br /> r TEF - t93.nO/hr FEE 553.00/hr FEE • ! 57.00/hr
<br /> _._.._._n •— — .—
<br /> l tOTAL M -- --
<br /> O(rl(t USE ONLY 2-� �---.
<br /> 5r1O.DU E
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<br /> rlfW'•' •'1> )M�, yY +tAv _ . #,YIr Y11Yra1, /,.A511 ,1L1.C1V�U InY MNM MM, Il 1
<br /> vax+s, . � � ����E���,y ;
<br /> x �C� '
<br /> x � Amar NYw nr,
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<br /> �M
<br /> �ylnW All
<br /> I�»I7 Qf Y
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<br /> � ,,.nr,>,rnm,xx«+mY�,r mzr>erxmvo:a>.,mx nnwmzsmaNsreaaawrrmwa,aewr,wwa�i,a�iw i�rxr�rn'�ir'�il:wea N'�irav+:s m�v�a+w u"av i+w'�e ar±.a
<br /> rN 21 03? (RFV 1/10/911 ft Pae! 11
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