Laserfiche WebLink
SAA JOAOUIN (�PUBLiC STORAGE <br /> SERVICES - E]IYIROMEYT�NE DIYSI01i <br /> STORAC� TANK PROGRAM FEE E1� <br /> S FACILITY SITE NAME FACILITY CONTACT NAME <br /> T <br /> E FACILITY ADDRESS SITE PHONE # with AREA CODE <br /> a <br /> CITY STATE ZIP CODE # of TANKS <br /> A 1uG CA �jS20 at SITE <br /> P <br /> P APPLICANT/BILLING ?LAME APPLICANT CONTACT NAME <br /> 1 u _ C v f .l-P <br /> C MAILING ADDRESS APPLICANT PHONE # WITH AREA <br /> N <br /> T CITY STATEJ ZIP CODE TTYPE of APPLICATION <br /> Fier, 1,114- C�4 �`1�� (Closure, Installs ion, etc.) v�U rCvwr�u fin+„ <br /> TOTAL <br /> 1986 1987 1988 1 1989 1990 <br /> ANNUAL FACILITY FEE (Prior to January 1, 1991) = $100.00 <br /> A XXXX X)= s <br /> C <br /> T FACILITY PENALTY FEES ASSESSED (If Applicable) xxxx xxxx s <br /> I <br /> V TANK FEE = S50.00/7ANK (Prior to January 1,1991) 5170/TANK (After January 1, 1991) <br /> E <br /> # Tanks = 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 <br /> F (multiply # by fee for <br /> A each year applicable) xxxx XXXX 5 <br /> C <br /> I TANK PENALTY FEES ASSESSED xxxx xxxx = <br /> L <br /> I STATE SURCHARGE = $56.00 each TANK (Due every 5 years) See California H & S Code, Section 25287 <br /> T <br /> Y # Tanks x $56.00 1988 through 1990 1991 through 1996 <br /> (Enter amount and year) <br /> S <br /> C PERMANENT CLOSURE (Removal or Authorized Closure-in-Place) TANK I.D. #(s) <br /> L <br /> 0 CLOSURE FEE = S78.00/hour (3 hours minimum/TANK) # TANK(s) X $234.00 = f <br /> S <br /> U TEMPORARY CLOSURE (Plan Review $ Inspections) TANK I.D. 9(s) <br /> R <br /> E TEMPORARY CLOSURE FEE = 578.00/hour (3 hours minimum/TANK) # TANK(s) X 5234.00 = 5 <br /> P INSTALLATION PLAN CHECK (Pian Review & Construction Inspections) TANK I.D. #(s) <br /> L <br /> A <br /> N PLAN CHECK FEE = S78.00/hour (8 hours minimun/FACILITY) = $624.00 minimus s <br /> R REPAIR FEE (Workplan Review 8 Construction Inspections) TANK I.D. #(s) <br /> E <br /> P TANK LINING REPAIR FEE = S78.09/hour (3 hours minimum/TANK) # TANK(s) X 5234.90 = S <br /> A <br /> I TANKRETR EE 578.00/hour (3 h rs min./FACILITY) = 3234.00 minimus S <br /> R - <br /> PI G R€PAIR FEE = s /hr m <br /> our (3 houinimum/FACILITY) = $234.00 minimus $ <br /> N 7 NSFER FEE 520.0 UNAUTHORIZED RELEASE EVALUATION = 378.00/hr 5 <br /> 1 <br /> S <br /> C CONSULTATION FEE = 578.00/hr SAMPLING INSPECTION FEE = S78.00/hr S <br /> TOTAL DUE $ rJ <br /> FOR OFFICE USE ONLY _ <br /> SWEEPS # COMPUTER # LOC CODE DIST CODE AMOUNT RECEIVED CHECK At/CASHf RECEIVED BY DATE RECEIVED <br /> ..... , .;. ter:-..-:::•:•......__: ::: -..::w <br /> WEH 23„032 (REVISED 6-21-93) Page 11 <br />