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SAN JOAOUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK PROGRAM - FEE WORKSHEET <br /> FACILITY SITE NAME FACIL17Y CONTACT NAME <br /> F I Ir ADDRESS SITE PHONE 0 with AREA CODE <br /> CITY STA)E zEpp6 at SITE <br /> STOCKTON ONE, IN GROUND <br /> l.A Ll1L <br /> APPLICANT/BILLING NAME APPLICANT CONTACT NAME <br /> FEDERAL DEPOSIT INSURANCE CORP. V1lJNDA BAKER <br /> �L,NgAD RF„S$.n APPLICANT PHONE M WITH AREA CODE <br /> �S� bORT B//E�ALC177H BT/1TE dtfFEWE CLOSURE, INSTALLATTYPE of IION, etc.CLOSURE <br /> l.A yL076 TOTAL <br /> 1986 1987 1988 1989 1990 <br /> ANNUAL FACILITY FEE (Prior to January 1, 1991) • $100.00 f <br /> TANK FEE %50.00/TANK (prior to January 1,1991) %170/TANK (after January 1, 1991) <br /> M Tanks • 1986 1 1987 1988 1989 1990 1 1991 1 1992 1 1993 1994 1995 1996 <br /> (oultyply feel for f <br /> each ear a <br /> STATE SURCHARGE • $56.00 each TANK (Due every 5 years) See California H i S Code, Section 25287 <br /> 0 Tanks x 556.00 1986 through 1990 1991 through 1996 <br /> (enter arrant amd year) S <br /> PERMANENT CLOSURE (Removal or Authorized Closure-in-Place) TANK I.D. !(s) <br /> CLOSURE FEE • $53.00 per hour (3 hours mininszo per TANK) 0 TANK(s)ONE K $159.00 • S <br /> TEMPORARY CLOSURE (A one-time permit, for review/Inspections) TAIK I.D. !(s) <br /> TEMPORARY CLOSURE FEE • $150.00 each TANK f TANK(s) _ K $150.00 • f <br /> PLAN CHECK (Install. Plan Review L Construction Inspections) TND: I.D. !(S) <br /> PLAN CHECK FEE - 153.00 per hour (8 hours minima per Facility) • $424.00 minieum S <br /> REPAIR FEE (workplan review i construction inspections) TANK I.D. /(s) <br /> TANK REPAIR FEE • $53.00 per hour (3 hours mini=WTANK) / TANK(s) K $159.00 • % <br /> PIPING REPAIR FEE 553.00 per hour (3 hour minims per facility • $159.00) S <br /> 11 TRANSFER FEE • $20.00 UNAUTHORIZED RELEASE EVALUATION • S53.00/hr S - -- <br /> CONSULTATION FEE 553.00/hr SAMPLING INSPECTION FEE • $53.00/hr S <br /> TOTAL DUE S l5q.00 <br /> F032sed 4/8/91) Page TWO -J� ' 'V <br /> 00 (6'-n&k <br />