COMPLIANCE INFO_2007-2010 - Laserfiche WebLink

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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.s,Igov.or /g ehd FACILITY NAME FACILITY CONTACT NAME 1IL E 6 C A- 0 1 C L/2 -4-- A w, o—tb A, A -P P r✓ e- T FACILITY ADDRESS SITE PHONE # WITH AREA CODE 3 3 0 T S 3 o F, Fr S' Q y® ( CITY STATE I ZIP CODE # OF TANKS AT SITE S Tp C (G Tn r( CA % S Z o APPLICANT BILLING NAME TANK ID # (s): T CONTACT NAME �,(/ L '�.0 ► E �i*Q G c �( F�2 � cW' k Li � APPLICANT MAILING ADDRESS 2007 EAPPLICANT PHONE # WITH AREA CODE 'F po 0 z s" $500 FEE INCLUDES FACILITY FEE + 1 TANK (2002-2007) 51 6 3 --3 -- /( Y-,2— CITY STATE ZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC # W C A 1 ?,5-6 R ( Closure Installation Repair tro it ACTIVE FACILITY TANK ID # (s): CLOSURE FEE = $315 / TANK 2003 2004 2005 2006 2007 2008 $500 FEE INCLUDES FACILITY FEE + 1 TANK (2002-2007) PIPING REPAIR FEE = $315 / FACILITY use for piping, under -dispenser containment, ect. $ SAMPLING INSPECTION FEE _ $ 105/ HOUR $550 FEE INCLUDES FACILITY FEE + 1 TANK (2008) $125 PER TANK AFTER FIRST TANK $ TANK PENALTY ASSESSED TANK SURCHARGE = $15 / TANK Is 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 = $315 / TANK # TANKS X $315 = TEMPORARY CLOSURE Plan Review and Inspections) TANK ID # (s) : TEMPORARY CLOSURE FEE = $315 / FACILITY INSTALLATION PLAN CHECK Plan Check and Construction Inspections) $ TANK ID # (s) : I PLAN CHECK FEE = $840 / FACILITY REPAIR PLAN CHECK TANK ID # (s) : $ TRANSFER FEE _ $ 20 TANK ETROFIT REPAIR FEE = $315 / FACILITY (use for monitoring equipment, cold starts, EVR upgrades, $ 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 / HOUR $ 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 # FACILITY ID AMOUNT RECEIVED CHECK # RECEIVED BY DATE RECEIVED SR EH 23 032 (REVISED 7/18/08)