Laserfiche WebLink
SAN j,-,-AUIN COUNTY PUELIC HEALTH SERVICES <br /> .� IRCNMEHTAL HEALTH OIVISICH <br /> UNDEAGR TCRAOE TANK PACCRA,M FEE UCAKSHEET <br /> TE•NAYP i!1 % • d 1 r +. FACILITY CONTACT HARE w' <br /> ' c:ILITY ADORES$ ;M SITE PXCNE tl with ;� E PAYME T <br /> 47cs / e"5 Acne ot- a. t%A^ <br /> c(rr I STATE (ZIP coot I : or TANKS ` � D <br /> �. <br /> at <br /> SITE J' 99' <br /> r. <br /> APP IGLNT/9ILLING AAME I APPLICANT CONTACT WE SAN JOAQUIN C UNTY <br /> / PUBLIC HEALTH S-RVICES <br /> ENVI ONMEMAL HEAL HDIVISIrW <br /> HAILING AOCRESS APPL[ TT ?ACNE 9 UITH'ARIA C67E <br /> ISTATE ZIP cwt TYP- of APPLICATION <br /> u 1�g� IC_GS RE, INSTALLAiiCN, etc. UU� <br /> 1586 11587 11518 i 1989 11950 uld <br /> t FEE (Prior to January 1, 1991) 5100.00 5;0,.. 'A.VX (prior :o January 1,1541) I 51' -'MX (ager January 1, 1951) <br /> 1986 1981 1SE8 1589 I 11591 1592 1593 1994 1955 1556!r_ ( I I I ISNOe)E Sc, Ac . ch.TANK (Oce :very S years) See Call,`ornla 4 S S Cxle, S/Ctlen Z5;-i <br /> Tarks_, z 5;6.00 1516 threu5h ISN thr-ugh 1596 owe <br /> (enter amcta�t arC you) � <br /> �" UI 15 l rlr- <br /> PE.2wA.NENT CL:••CRS (Removal or AUthori Ove C(csurs-in•Pt ace) I TANK I.O. S(s) <br /> CLCSLSE FEE ■ $5340 per hour (3 hears mWour•s Per TA491 I : TANX(s)� -44„ X 1159,00 • s 177-so <br /> : I <br /> TLPCAARY CLC=RE (A orae-time permit, for review S inspcctiena l TANK I.O. A s) <br /> ` r e t o I ""TANX(s) _X 5150.00 ■ 5 <br /> : TEMPORARY C.OSUA_ FE_ 5150.00 each TANK <br /> a PLAN <NEOX (Imull. Plan Review S COm truetion Impel, I TANK 1.7. =<5) <br /> xPLU C,3t.: FEE • $53.00 per hour (a hcurs.miniatm per Faeilit ) a S424.CO minfam I S ' � o-J, <br /> T I REPAIR I TAxz I.O. E(s) <br /> 7 TANK REPAIR FEE + 55340 per hour (3 hours minlaam/TANX) I P TANX(s) _ X <br /> R PIPING REPAIR REVTEU 3 CONSTRUCTION a 553.00 Per hour (3 hour miniper taciliry + 5159,00) <br /> c JIsvLTArtcus 1 UNAUTHORIZED RELEASE cIALVAIIGN I SAMPLING INSPECTION SAN OAQUIN COUNT <br /> 'PUBLICHEALTH SERVI -S <br /> S IJiOr� <br /> c rES a 55;.00/fir _ I I FEE a 553.00/hr I I FEE a S 53.00/hr <br /> TOTAL Out S �� ) <br /> OFFICE USE ONLY <br /> _ •��— FiYw•:lM�-�T—i:M:.�.�--M—•.W wi!IY.:m`.�.�l,.ffSW1Y y.M:i'Jf M:W!A,'Mw+v.+i,��Yw.w F-••'il���W w�+r.�w— <br /> li1/�-"i Y..—Ai+� a�]W�.•Y.1t9:'%ir'�'�' iF'. wv'%.w-._:Al.^..s .'#�5""f^±T-._..,. .�.y�"i'".p'Ti' '.'7TPF.^-MY4KJ��i^JV='tWu•� <br /> rnCdlle- <br /> 3•(��� n:•__rvev rc Y(� .a • <br /> a <br /> I d 91 : 91 16/01/9d" WONJ <br />