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S <br />t <br />T <br />E <br />t <br />A <br />P <br />P <br />L <br />I <br />C <br />A <br />N <br />T <br />FACILITY SITE <br />ANNUAL FACILITY FEE (Friar to January 1., 1991) ■ 1100.00 <br />t 1987 19m 19M 1990 <br />0 <br />FACILITY CONTACT <br />$ <br />�' � <br />ANASTASIO' S <br />AM/PM MINI <br />MART Jack Anas" `L HEALTH <br />FACILITY MORESS <br />! <br />I <br />St TE PNQNE ! with AREA CGDE <br />3425 Tracy <br />Blvd <br />TANK FEE : SSO.00/TANK (Prior to January 1,1941) <br />(209) MID <br />E <br />CITY <br />i TjNft 4 1986 1987 1988 1949 <br />t 1941 1942 IM 1994 1995 1996 <br />STATE <br />CODE F704 TANKS <br />(multipty ! try fee for <br />Trac <br />CA <br />[ZIP <br />95376 °t SITE 4 <br />APPLICANT/BILLING NATE <br />$680.00C <br />APPLICANT CONTACT <br />ANASTASIO'S <br />AM PM MINI <br />MART Pete Tobin or Chester Benne <br />NAILING MORES$ <br />L <br />APPLICANT POW ! YITN AREA CODE <br />I <br />3425 Tracy <br />Blvd <br />(916) 635-2444 <br />CITY <br />STATE <br />ZIP E of ICATION <br />1941 th 1998 <br />Trac <br />CA <br />95376 icctow", Inststtsttae etc )Installat' <br />TOTAL <br />P INSTALLATION (Ptan Review i Cmutriation t i ) TAK 1.0. Its) <br />L <br />A <br />N PLAN CUM ME * .00to hours a tinloaWFACYLITY) sSM.00 minium: <br />N TRANSFER FEE a 520.00 <br />S <br />C CON8ULTATION FEE ■ SM.00/hr <br />FOR OFFICE Use ONLY / V 7— <br />WWWRORIZED RELEASE EVAUIATtON a M.00/hr <br />SNPLING tullECTION FE a 178. r <br />11 <br />EN 23 032 (REV( 3.1-451 <br />ANNUAL FACILITY FEE (Friar to January 1., 1991) ■ 1100.00 <br />t 1987 19m 19M 1990 <br />0 <br />C <br />% <br />! 0 <br />T <br />FACILITY PENALTY FEES ASUSM cif Applicable) <br />! <br />I <br />9 <br />Y <br />TANK FEE : SSO.00/TANK (Prior to January 1,1941) <br />S1 (After Jonwry 1, 1941) <br />E <br />i TjNft 4 1986 1987 1988 1949 <br />t 1941 1942 IM 1994 1995 1996 <br />F <br />(multipty ! try fee for <br />A <br />esah year sePt l"Ke) <br />$680.00C <br />I <br />TANK MALTY FEES ASSE <br />! <br />L <br />I <br />STATE SURCHARGE a SS6.00 each TANK (Ow every 5 ) <br />See Californie N i S Code, Section 25287 <br />T <br />T! <br />Taft 4 art SS6.00 1 thromb im <br />1941 th 1998 <br />(Enter emmm and year) <br />224.00 loolm-m*224.00 <br />P INSTALLATION (Ptan Review i Cmutriation t i ) TAK 1.0. Its) <br />L <br />A <br />N PLAN CUM ME * .00to hours a tinloaWFACYLITY) sSM.00 minium: <br />N TRANSFER FEE a 520.00 <br />S <br />C CON8ULTATION FEE ■ SM.00/hr <br />FOR OFFICE Use ONLY / V 7— <br />WWWRORIZED RELEASE EVAUIATtON a M.00/hr <br />SNPLING tullECTION FE a 178. r <br />11 <br />EN 23 032 (REV( 3.1-451 <br />