Laserfiche WebLink
SAIW OAQUIN LOCAL HEALTH &TRICT <br />UNDERGROUND STORAGE TANK PROGRAM - FEE WORKSHEET —16 <br />— /n <br />F <br />FACILITY/SITE NAME <br />FACILITY,CONTACT NAME <br />A <br />C <br />rJ u crin Cc, - <br />` <br />,v /C/,-- l� Pf <br />L <br />T <br />STREET ADDRESS <br />/7% <br />SITE PHONE t WITH AREA COD[ <br />'9" C/Y— 3 <br />$ <br />F <br />— <br />Y <br />CITY <br />�I,GIC�o�r <br />STAT <br />ZIP CODE <br />t of Tanks <br />at Site <br />A <br />APPLICANT/BILLIN6 NAME <br />APPLICANT CONTACT NAME <br />P <br />FEE = 130.00/hr <br />P <br />FEE _ $35.00/hr <br />FEE = <br />L <br />-- <br />1 <br />1 <br />MAILING ADDRESS <br />APPLICANT PHONE t WITH AREA CODE <br />C <br />$ <br />A <br />N <br />CITY <br />STAT <br />IIP'CODE <br />TYPE of APPLICATION <br />T <br />CLOSURE, INSTALLATION, ETC. <br />FACILITY FEE = $100,00 each SITE ADDRESS per YEAR <br />--— 19887 <br />ICIT NI' CCC - ICI n1 - ..L 1 _ <br />PRECISION INDUSTRIES, INC. <br />f- 1041 S. PERSHING AVE. <br />t'_, STOCKTON, CALIFORNIA 95206 <br />(209) 462-9911 <br />r4P ^ <br />,! JEG ISrt1Y1i6b���CC1 0 DOLSO C71 <br />PA`s <br />1988 1989 <br />CALIF ORNIANFIRST BANK <br />vo9 <br />—T co..... 000 oRivc - aroccron, cw navv <br />iliOC1iL ,M CQ�T. <br />II.001,26Slim 1:1 2 1 100494a: 68 036531 <br />fi- <br />TOTAL <br />S <br />90-49 _ <br />1,20 oR <br />4265 <br />REPAIR <br />F. TANK REPAIR FEE _ $110.00 each <br />E <br />TANK <br />t Tanks ---- <br />: $110.00 <br />$ <br />F <br />— <br />A PIPING REPAIR,/CLOSURE/REMOVAL <br />I <br />(Fees are per hour, minimum one hour to be <br />paid on plan submittal) <br />R UNAUTHORIZED RELEASE EVALUATION <br />(When applicable) <br />CONSTRUCTION INSPECTION <br />(When applicable) <br />SAMPLING INSPECTION <br />(when applicable) <br />FEE = 130.00/hr <br />FEE _ $35.00/hr <br />FEE = <br />$35.00/hr <br />1 <br />TOTAL DUE <br />$ <br />OFFICE USE ONLY <br />SWEEPS t COMP 17-00070D, <br />Ei DIST CODE AMOUNT DUE AMOUNT RCVD <br />—7 o%ginoi13x3 aq o qo— <br />RCVD BY I DATE P,ECEIVED I PERMIT t <br />