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• S� JOAQUIN LOCAL <br /> ' --•- � ��''�"' U`N-D_E•-RGROUN �_--- HEALTH STRICTfFACIITTY/S!TENAME D_SiO_GtE TANK PROGRAM - FEE WORK58CET <br /> C S o l l i v a n & Mann dumber Co . FACILITY CONTACT NAME ' <br /> L STREET ADDRESS Mike mann <br /> 1 16177 So . McKinley <br /> T SITE PHONE 1 wrr" AasA`coaE <br /> Y CITY 209-858-4737 <br /> _Lathrop STATE IIP CODE 1 of Tanks <br /> A APPLICA �IN6 NAME CA 95330 a# Site <br /> P — I <br /> P Oil Equipment Service APPLICANT CONTACT NAME <br /> L -------''. Keith A .MAILING ADDRESS ----------. A T a l l i a <br /> A PO B o x 950 <br /> ""_--- <br /> APPLICANT PHONE II wirN AREA CODE <br /> N CITY "-- -- 2 0 9-7 5 4- 18 0 8 <br /> San A n d r e a s����- SCAA IIP CODE TYPE of APPLICATION <br /> �--------- 952.49 ININrAILATiON, ErC. <br /> FACILITY FEE = $104.00 each SITE ADDRESS per YEAR Removal <br /> T 1986lgal �- - TOTAL <br /> ! 1988 1589_____ <br /> V ---��� <br /> E rAH` K FEE -J0,00 each TANK <br /> F 1 Tanks x $50.00 <br /> A (aultipry-r-by fee for 1986 1981+I= 1988eachYear applicable) 1_989 <br /> STATE SURCHARGE = $56.00 each TANK (see CA HEALTH b SAFETY CODE <br /> T I Tanks x 356.00 _-`" Sec 25281 for applicability) <br /> Y (enter amount and year) 1986 1987 ------_.� <br /> 1988 198'3 <br /> --_ <br /> C PEP.MANENT CLOSURE (ReAoval or Closure-in-place) -�-� <br /> 0 CLOSURE FEE = 190.00 <br /> 5 h TANK <br /> 1 Tanks___~ x $:Of04 150 . OQ i <br /> P. TEMPORARY CLOSURE {Only al loved one time for up to tvo Years) 150 . 00 <br /> E <br /> TEMPORARY CLOSUREFEE=$80,00 each TANK <br /> Tanks <br /> - 1 �---- "__ <br /> �T� _ x $80.00 <br /> P PLAN CHECK (Installation or Repair) <br /> L <br /> h PLAN CHECK FEE $30,00 each SUBMISSION/kESUCMISSION- <br /> REPAIR _- -- - $ <br /> P, TANY REPAIR FEE= $110,00 each TANK <br /> E-__--�_,__ _�-� 1 Tanks <br /> P __ �_ �_.__ ------ x $110.00 $ <br /> A PIPING REPAIR/CL05UF,E/REItOVAI- (Fees are per hour, minimum one hour to be <br /> R UNAUTHORIZED RELEASEE EVALUATION COHSTRUCiCOH INSPECTION paid on plan submittal) <br /> ("hen applicable) SAMP�IHG SPEGIIOH <br /> FEE (when applicable) <br /> (when applicable) <br /> in <br /> — <br /> (when$30,00/1ir _ -- - ,. _ i <br /> --___ _ FEE = $55.00/hr �E <br /> Dff10E USE ONLY TOTAL DUE ; <br /> aim <br /> SWEEPS I � i ff I n 1< <br /> COMP I LOC CODE DIST CODE AMOUfIT DUE AMOUNT R�rV�D ,.(i11, f�! igt�� � , '1� 4`gu!8l I I Z <br /> - �{� 1 <br /> �2` j Svte .ASH RCVD OY DATE RECEIVED PERMIT 1 <br /> _-___ <br /> � i IQI! I f.II',l � 1 ;lP('17' n �7L ---------__._...._ <br /> 7�1v � n1w 7 -- <br /> " I' ''• �I�'` �V19�1! Y <br />