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9255517888 Line 1 12:24:39 p.m. 12-08-2008 4/12 SAN JOAQUIN COUNTY " •_' ENVIRONMENTAL HEALTH DEPARTMENT FL 600 East Main Street,Stockton,CA 95202-3029 �t. Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.ora/ehd FACILITY NAME FACILITY CONTACT NAME ARCO 6080 FACILITY ADDRESS SITE PHONE N WITH AREA CODE 85 E LOUISE AVE 925 551-7555 CITY STATE ZIP CODE X OF TANKS AT SITE L TTHROP CA 95330 APPLICANT BILLING NAME APPLICANT CONTACT NAME Gettler Ryan Inc. LIDDY MCKENZIE APPLICANT MAILING ADDRESS APPLICANT PHONE#WITH AREA CODE 6747 6747 Sierra Court,Suite J 925 551.7555 CITY STATE I ZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC# Dublin I CA 94568 Closure Installation Repair Retrofit 5252314-U I ACTIVE FACILITY 2003 2004 2005 2006 2007 2008 $500 FEE INCLUDES FACILITY FEE+1 TANK(2002-2007) $550 FEE INCLUDES FACILITY FEE+1 TANK(2008) $125 PER TANK AFTER FIRST TANK $ TANK PENALTY ASSESSED TANK SURCHARGE=S15rTANK STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM =$24.00/FACILITY PERMANENT CLOSURE Removal or Permitted Closure in Place TANK ID#(s): CLOSURE FEE=$3151TANK 1 #TANKS X$315= TEMPORARY CLOSURE Plan Review and Inspections) TANK ID#(s): TEMPORARY CLOSURE FEE=$315/FACILITY INSTALLATION PLAN CHECK Pian Check and Construction Inspections) $ TANK ID#(s): PLAN CHECK FEE=$840/FACILITY REPAIR PLAN CHECK TANK ID#(s): $ TANK RETROFIT REPAIR FEE =$315/FACILITY (use for monitoring equipment,cold starts,EVR upgrades, 315 spill buckets,sumps.misc. $ PIPING REPAIR FEE=$315/FACILITY use for piping,under-dispenser containment,ect. MISCELLANEOUS $ TRANSFER FEE = $20 CONSULTATION FEE = $105/HOUR UNAUTHORIZED RELEASE EVALUATION FEE = $105/1-10UR SAMPLING INSPECTION FEE = $105/HOUR ALL FEES ARE BASED ON THE$105 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. OFFICE USE ONLY SERVICE REQUEST f 1 FACILITY ID AMOUNT RECEIVED I CHECK# 1 RECEIVED BY DATE RECEIVED SR I I I j EH 23 032(REVISED 71111100)