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19255517888 Main Fax GETTLER RYAN INC 11 '():52 a.m. 03-09-2007 3/11 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3rd Floor, Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Far(5"r floor):(209)468-3433 Web:www.siaov.orwehd <br /> FACILITY NAME FACILITY CONTACT NAME <br /> UNION766100 NILESH PATEL <br /> FACILITY ADDRESS SITE PHONE#WITH AREA CODE <br /> 25775 S PATTERSON PASS 925 551-7555 <br /> CITY STATE I ZIP CODE #OF TANKS AT SITE <br /> TRACY CA 93292 <br /> APPLICANT BILLING NAME APPLICANT CONTACT NAME <br /> Gettler Ryan Inc. LIDDY MCKENZIE <br /> APPLICANT MAILING ADDRESS APPLICANT PHONE#WITH AREA CODE <br /> 6747 Sierra Court, Suite J 925 551-7555 <br /> CITY STATE ZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC# <br /> Dublin CA 94568 Closure Installation Repair Retrofit 5250447•ul <br /> ACTIVE FACILITY <br /> 2000 2001 2002 2003 2004 2005 <br /> $500 FEE INCLUDES FACILITY FEE+1 TANK <br /> $125 PER TANK AFIER FIRST TANK <br /> TANK PENALTY ASSESSED $ <br /> TANK SURCHARGE=$15/TANK $ <br /> STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM=$24.00/FACILITY $ <br /> PERMANENT CLOSURE <br /> Removal or Permitted Closure in Place <br /> TANK ID# s CLOSURE FEE=$279/TANK #TANKS X$279= $ <br /> TEMPORARY CLOSURE <br /> Plan Review and Inspections) <br /> TANK ID#(s): TEMPORARY CLOSURE FEE_$2791 FACILITY $ <br /> INSTALLATION PLAN CHECK <br /> Plan Check and Construction Inspections) <br /> TANK ID#(s): PLAN CHECK FEE_$7441 FACILITY <br /> REPAIR PLAN CHECK <br /> TANK ID#(s): <br /> TANK RETROFIT REPAIR FEE =$279/FACILITY use for monitoring equipment.spill buckets,tank sumps,mist. $ 285 <br /> PIPING REPAIR FEE _$279/FACILITY use for piping,under-dispenser containment,ect.) $ <br /> MISCELLANEOUS <br /> TRANSFER FEE _ $20 $ <br /> CONSULTATION FEE = $93/HOUR $ <br /> r <br /> HORIZED RELEASE EVALUATION FEE - S 93/HOUR $ING INSPECTION FEE _ $93/HOUR $ <br /> ALL FEES ARE BASED ON THE$93 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. <br /> OFFICE USE ONLY <br /> SERVICE REQUEST# FACILITY ID AMOUNT RECEIVED CHECK# I RECEIVED BY I DATE RECEIVED <br /> SR <br /> EH 23 032(REVISED 02/22105) <br />