COMPLIANCE INFO 1985 - 2001 - Laserfiche WebLink

Home Browse Search

i SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES-ENVIRONMENTAL HEALTH DIVISION UNDERGROUND STORAGE TANK PROGRAM FEE WORKSHEET FACILITY NAME FACI ITY CONTACT NAME `OWUC L�k Lbsyka- .A.L ADDRESS SITE PHONE#WITH AREA CODE a�131 Lt Y1�w1r1 msvai 94 - T #)- CITY STATE ZIP CODE #OF TANKS AT SITE Cb CA y APPLICANT BILLING NAME APPLICANT CONTACT NAME Lo � � APPLIC NT MAI ING ADDRESS APPLICANT PHONE#WITH AREA CODE i nox 300 � o zo - g3�/ CITY STATE ZIP CODE CIRCLE WORK TO BE DONE: S-d� ��•� Q 5213_D Q 0 Closure Installation Repair elro8t ACTIVE FACILITY 1996— 1999 2000 2001 i $500 FEE INCLUDES FACILITY FEE + 1 TANK Is 170)X(a ranks)X(a of years applIcable) $125 PER TANK AFTER FIRST TANK S S TANK PENALTY ASSESSED S TANK SURCHARGE=$8/TANK S STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM=$10l FACILITY I PERMANENT CLOSURE Removal or Permitted Closure in Place S TANK IDIS): CLOSURE FEE=E287/TANK #TANKS X$267= TEMPORY CLOSURE Plan Review ano Inspections) S TANK ID#(s): TEMPORARY CLOSURE FEE_$267/FACILITY INSTALLATION PLAN CHECK 1 Plan Check and Construction Inspections) S TANK 10#(s): PLAN CHECK FEE_$712/FACILITY REPAIR PLAN CHECK TANK ID#(S): S , TANK LINING REPAIR FEE =$267/.TANK #TANKS X$267= S TANK RETROFIT REPAIR FEE =$267/FACILITY _ S PIPING REPAIR FEE _$267/FACILITY MISCELLANEOUS S i TRANSFER FEE _ $20 11 CONSULTATION FEE = $89/HOUR S UNAUTHORIZED RELEASE EVALUATION FEE _ $891 HOUR S S SAMPLING INSPECTION FEE _ $89/HOUR ALL FEES ARE BASED ON TME fee HOURLY RATE..TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT, OFFICE USE ONLY SERVICE REQUEST a FACILITY 10 I AMOUNT RECEIVED CHECK# I RECEIVED BY I DATE RECEIVED SR EH 23 032(REVISED 11.1-011