Laserfiche WebLink
UNDERGROUND STORAGE TANK PROGRAM - FEE WORKSHEET <br /> F TACILITY/SITE NAME FACILITY CO NAME <br /> � ' Larry W. Aksland, Inc. Larry W. Aksland <br /> I <br /> L STREET ADDRESS SITE PHONE 1 (vith Area Code) <br /> 1 8282 Veritas Avenue 209 3- <br /> Y CITY STATE ZIP CODE 1 of TANK'S <br /> Manteca CA 95336 at Site 1 <br /> p APPLICANT/BILLING NAME APPLICANT CONTACT NAME <br /> F <br /> P same <br /> L <br /> I MAILING ADDRESS APPLICANT PHONE I (vith Area Code) <br /> C <br /> A <br /> N CITY STATE T1P CODE TYPE of APPLICATION Tank Removal <br /> T (Closure, Installation, etc.) <br /> A FACILITY FEE _ 1100.00 each SITE ADDRESS per YEAR TOTAL <br /> T 1986 1987 1908 1909 <br /> I t <br /> V — <br /> E TANK FEE = 150.00 each TANK <br /> F 1 Tanks x 150.00 1986 1987 1988 1989 <br /> A (multiply-i-by fee for <br /> Ieach year applicable) f <br /> STATE SURCHARGE = 156.00 each TANK (see CA HEALTH 1 SAFETY CODE Sec 25281 for applicability) <br /> T 1 Tanks x 156.00 1986 1987 1988 1989 <br /> Y (enter iiiuiit and year) <br /> f <br /> C PERMANENT CLOSURE (Removal or Closure-in-place) <br /> L <br /> O CLOSURE FEE = 190.00 each TANK 1 Tanks <br /> 5 _t _ x 190.00 f 90.00 <br /> U <br /> R TEMPORARY CLOSURE (Only alloved one time for up to tvo years) <br /> E <br /> TEMPORARY CLOSURE FEE = 180.00 each TANK 1 Tanks x 180.00 f <br /> P PLAN CHECK (installation or Repair) <br /> L <br /> A <br /> N PLAN CHECK FEE 130.00 each SUBMISSION/RESUBMISSION f <br /> REPAIR <br /> P. <br /> E TANK REPAIR FEE = 1110.00 each TANK 1 Tanks x 1110.00 1 <br /> P <br /> A <br /> I PIPING REPAIR/CLOSURE/REMOVAL (Fees are per hour, minimum one hour to be paid on plan submittal) <br /> UNAUTHORIZED RELEASE EVALUATION CONSTRUCTION SAMPLING <br /> (vhen applicable) INSPECTION INSPECTION <br /> FEE = 130.00/hr FEE = 135.00/hr FEE = 135.00/hr f <br /> TOTAL DUE Is <br /> OFFICE USE OAIr <br /> SWEEPS 1 COMP 1 LOC CODE DIST CODE AMOUNT DUE AMOUNT RCV CHECK 1/ SH RCVD BY DATE RECEIVED PERMIT 1 <br />