Laserfiche WebLink
SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> DERGROUND STORAGE TANK PROGRAM - FEE WORKS <br /> FIFACILIIY/SITE NAME FACILITY CONTACT NAME <br /> A <br /> C Denevi Herbert Briggs <br /> L STREET ADDR 55 SITE PHONE t WITH AREA CODE <br /> E <br /> I 5555 Shippee Lane <br /> (209) 951-6261 <br /> Y CITY STATE IIP CODE R of Tanks <br /> Stockton Ca at Site I <br /> A APPLICANT/BILLING NAME APPLICANT CONTACT NAME <br /> P <br /> P Wells Fargo Bank, N.A., Trustee Sandra Getz <br /> L .._..—_.—._._..._...._._.... --__..__.-.. -_ -- -......-- -------- - -------- <br /> I MAILING ADDRESS APPLICANT PHONE t WITH AREA CODE <br /> 400 Ca itol Mall (9160 440-4941 <br /> N CITY STAT i1PSi DE TYPE of APPLICATION Method has not bee <br /> _— 95 4 ----- <br /> T Sacramento CA TCLOSURE, INSTALLATION, ETC. determined <br /> - -- - - ------ -- ---- - — - -- I_— — -- —.� <br /> FACILITY FEE _ $100.00 each SITE ADDRESS per YEAR ' TOTAL <br /> A .................-..----------- -— - - - — <br /> T 1386 1987 1988 1989 <br /> VI —..l. Q._.__..J_4�_ _1_�_ —_-. ' foo <br /> ....- ------------ - <br /> E TANK FEE _ $50.00 each TANK <br /> _.........- - ... .........----------._---_-------- <br /> _ ..........._...... - - ..... -- -......-.._......... <br /> F t Tanks x $50.00 1986 1387 1988 1989 <br /> A (multiPTy�I by fee for -... -- — - - _ -- <br /> C each year applicable) (� $ � <br /> L STATE SURCHARGE = $56.00 each TANK (see CA HEALTH 6 SAFETY CODE Sec 25287 for applicability) <br /> T t Tanks 1 x $56.00 1986 1 1988 1383 <br /> Y (enter mount and years -- -- 987 <br /> C PERMANENT CLOSURE (Removal or Closure-in-place) <br /> D CLOSURE FEE = $90.00 each TANK t Tanks 1 z (90.00 f <br /> R TEMPORARY CLOSURE (Only allowed one time for up to two years) <br /> E - ------- - - - — — -- ----- -------- — - — - <br /> TEMPORARY CLOSURE FEE _ $80.00 each TANK f t Tanks x $80.00 f <br /> _.. -_._......_.. ..._.._.. -- ------------ <br /> P <br /> P PLAN CHECK (Installation or Repair) <br /> L <br /> A <br /> IN PLAN-CHECK FEE _ $30_00 each SUBMISSION/RESUBMISSION _—--- - ---�` $ <br /> R TANK REPAIR FEE _ $110.00 each TANK It Tanks x $110.00 f <br /> -- - - <br /> E .._...... -- - - ....._.. -- ----._ __....-....._...- - .._......._.........__.............__..._._._...... ------ <br /> A PIPING REPAIR/CLOSURE/REMOVAL (Fees are per hour, minimum one hour to be paid on plan submittal) <br /> ( ..._..-_.....- - -- --- -- --- ------------------ - ------- -- - — <br /> R UNAUTHORIZED RELEASE EVALUATION CONSTRUCTION INSPECTION SAMPLING INSPECTION <br /> (when applicable) (when applicable) (when applicable) <br /> FEE = $30. OAT FEE = $35.00/hr FEE = f35.00/hrf f <br /> TOTAL DUEL60�G3�o 60 � <br /> OFFICE USE ONLY 71w, bc( �IhQq <br /> n119171IIINIIm,11 1111OilmBONlm ]THPI r1111111IN911011 11011 m01IN9lml���!�In��mII�III�Ilaum111111111fiG�IIII�ImI111n,Nm11l�'ll�l�lll�olfl1��l��m II�IIII���IIJ! ll�d���l��'l��lIII�II�II�f��Pl�il�l��A. U I <br /> SWEEPS t COMP t LOC CODE DIST CODE AMOUNT DUE AMOUNT RCVD CHECK t/CASH RCVD BY DATE RECEIVED PERMIT t <br /> I I�pp!II�ppi�1.. :11� �I mlml' fI i111GII�liVT11111f.1i11111111111111111f111 SIIIJII11111111111i111!111 .1111111111111111u11�11111I11 II11i111111111�1�1111111 ; , 111111. „ 1111 �i1 .111111111.1111(II@I11�111111�!111111�11�i <br />