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.)Oct !(.!I C ' <br /> Slrec�t 1391: <br /> SAIOoAQ ' IN L_oCAL HCAL_r1i D <br /> UNOERGROUNp STORAGE TANK PROGRA4 - FEE WORYISHEET <br /> IFJFACILIIY/SITE HANE FACILITY CONTACT NAME <br /> li Sharpe Army Depot Jultll .1. G(wil ut <br /> L STREET ADDRESS SITE PHONE I Mr TN AmcA cpC6 <br /> IItotli Itoad, Environmental Program office (209) 982-1093 <br /> T _ _ r _--- -.— <br /> Y CITY STATE IIP CODE-J — <br /> at <br /> _..__._..... _.__....--•----.�_...__._.__..___._._._,._....- _ <br /> A APPLICANT/BILL1116 NAME -- APPLICANT CONTACT NANE <br /> P <br /> T' �T' PPc�T • <br /> L ..___...._._._..._.._....._.___.___..._._--•- -•---._...__-_ -_.... ..__.__..... __.. _ _.. ---__._.._. _._._--__--- _-- <br /> I NAILIN'i ADOPESS APPLICANT PHONE I! "(T" AREA coot <br /> tt CTT STATE TIP'CODE TYPE of APPLICATION <br /> CLOBUALW (NSTALLAT10N� TC. <br /> II'M IL11Y FEE = 1100.00 each SITE ADD?ESS per, YEAR TOTAL <br /> I. 1906 1987 1988 150) <br /> I T <br /> E TANK FEE = 150.00 each TANK <br /> f 1 Tanksr 150.00 1986 1987 1988 19013 <br /> A (•ultiply_1_by lee (or __-------_-.» __.---.__..__. _._._. -.._.. _.__...____.._._-. -----_ — ..--� ----•--._____._._. <br /> each year applicable) T <br /> L STATE SURCHARGE % 156.00 each TANK'(see CA HEALTH 1 SAFETY CODE Sec 25207 for applicability) <br /> 1 I Tanks T 156,00 1986 1987 1908 1984 <br /> Y (enter iiuunt and year) <br /> �:rPEP,IfA•Nf:N� �';�Reaoval or Clasure-in-piace)--_._..._.__._....__._...__.._.----_•--•._...._,..__...___._..__._.--'--. -.----- <br /> I. _._._..._._..._......_:._........_�_..---- -__---- -- _ <br /> 0 ('LOSUPE FEE �� 4. Ogt�h TANL` _- -- __. 1 Tanks x 140.00 1 <br /> po <br /> F IENPOP.ARY CLOSURE (Only alloyed one tine for up to tvo years) <br /> fENPORAPY (1.051IRE FEE o $80.00 each TANK. I Tank; a 190.00 1 <br /> P PLAIT f•II:CK tlnslallalian or Repair) <br /> L ........._.-._......___.....__..._......_.__..._._..___........._.._.....-----_._.__._.__.._......._..._._.-_--_._......... <br /> __:___.._...__......._ <br /> A <br /> II PLATT CHECK. FEE = 130.00 each SUBMISSION/6ESUCHISSION 1 <br /> ..........._..._.....____.._._..__---..___—_.__..____..._-----__._____.__..____.____._._.__._..----.. _..__--•-•--_---__-..J.—_._...___.___.._--_-_-- <br /> ........__.......__.._ -- <br /> PEPAIR <br /> P. TANI: FEPAIR FEE = 1110,00 each TANK ( I Tanksx 1110,00 S <br /> f' <br /> A PIPING REPAIR./CLOSURE/P,ENOVAL (Fees are per hour, mini Rua one hour to be paid on plan submittal) <br /> l .... _...._ . ._.. _....._.__._.....__...._.._ ... ..._...._........._...._.._..........__._...:__....»_..--- _ ....._......._...... <br /> _ .. ........-- <br /> R UNAUMOP..IIED RELEASE EVALUATION CONSTRUCTION INSPECTION SAMPLING INSPECTION <br /> (vhen appircabte) (when applicable) (-when applicable) <br /> FEE 139.nQlhr -_ _ FEE 135.40/hr fEE = 135 00th, } �- <br /> I <br /> _.1......_. -...._.__.. <br /> D2� <br /> TOTAL DUE <br /> DIM( USE DYIY <br /> tl. �p �x�x qp� �pq I y1� ., t g�'p �1 1 1 1r!''rP��nnry�� PP n��1 h 't'1 A 1• .y+::ay.!ry 1,. 1+ ,..,r,..•,..,... <br /> ,tIf.LPS ! tONP 1 LOC CODE DIST CODE AMOUNT putt ANOINII R00 CH M: I/fAS11 la'!p 11Y WE PEI:EI'.F.O PT1'1111 <br /> 1 1 flN N 1 ?11 I T 1 P 1 � W 1 1M11_P M 1"rT�+1'PM!rN P' 1 1 +PI <br /> It:"T" /�1Wt"y' P' C�,J" '(yyyryll��'1elp��p �{p�.1q'y �1►1� 9y gp� y gq)�11 I1�;PI F!T PNA(,I,11r.��p1�1gry��� 1111 IeP+r 1�,1y1�P w',o. r.1:{It? r�I ,. y. I: 7,� 1 <br /> • �,1IJ .. 1.11' ' ;11WAYJHL: :f4.4Fi+t1.. . i Y< �WM ..!'�wtYl�Yl '�1p-1'f•4 P IAr. 'I':i t I �R S�'.fif.�,'li 1.: 1`„.�iei:lalt4 1 f <br /> Ea'W'.T 1�]i F.E915C {((178 1 <br />