Laserfiche WebLink
SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES-ENVIRONMENTAL HEALTH DIVISION Q001,5Y <br /> UNDEKGROUND STORAGE; TANK PROGRAM - FEE WORKSHEET <br /> S FACILITY SITE NAME FAt'W7•Y CONTACT NAh1E <br /> I Lawrence LivermoreNatn•nal Lah•rat.•n(LLNI.) l' Suw 1ack.on <br /> T FACILITY ADDRESS SITE P110M.a%oh AREA('ODI: <br /> E Corral Hollow Road (Sial 423-t##I <br /> & C3TY STATEZII't'ODt #AF TANKS at SITE <br /> A (southwest of Tracv) ('A 94-N 1 for Buildine R36A <br /> P APPLICANIBILLRdGNAME APPLK'AtvTL'ONia(TNAN1E <br /> P LLNL ('. Sup( Jack..ro <br /> L MAILING ADDRESS APPLICANT PHONE#WITH AREA CODE <br /> 1 7000 East Ave..P.O. Box 809. (510)_423-6577 <br /> C CITY STATE ZIP CODE TYPE OF APPLICATION(Closure.Installation.etc.) <br /> A <br /> N Livermore CA 94550 Tank cN•sure <br /> T TOTAL <br /> A ANNUAL FACILITY FEE(Prior k, 1986 1987 1988 1989 1990 <br /> C January 1. 1991) =5100.00 S <br /> T <br /> I S <br /> V FACILITY PENALTY FEES ASSESSED xxxx xxxx <br /> E (if a licable) <br /> TANK FEE=550.0o/TANK(Pnor to January 1. 1991) 1701 TANK <br /> After Janu 1. 1991) <br /> F #Tanks = 1986 1987 1988 1989 1990 199! 1992 1993 1994 1995 1996 <br /> A (multiply #by fee for S <br /> C each year applicable <br /> I S <br /> L TANKPENALTY AAA xxx <br /> I FEES ASSESSED <br /> T STATE SURCHARGE=S56 each TANK(Due every 5 year,)See California H&S CW .Section 21,287 <br /> Y <br /> #Tanks= x 556.00(enter amount and year( 1 1996 through 1990 . i`J9l through 1996 <br /> S <br /> C PERMANENT CLOSURE(Rcmnval or Auth.xized Cktiane-in-Pljkv <br /> L <br /> O CLOSURE FEE-S78.00/hour 0 hoots mintmumITANK) TANK I.D.#(s)- 1_x 52-34.00= S 23 i ,. <br /> S <br /> U TEMPORARY CLOSURE(Plan Review&Inspect'—s) TANK I.D. <br /> R #(s) <br /> E TEMPORARY CLOSURE FEE=578.00/hour <br /> (3 lotus minimum/IANK) <br /> P INSTALLATION PLAN CHECK(Plan Review dt Construction TANK I.D. #(s) <br /> L Ins ctions) <br /> A PLAN CHECK FEE-S78.00/hour(8 hours minimumfFacihty)=5624.00 minimum S <br /> N <br /> FRR REPAIR FEE(workplan Review&Construction Inspections) TANK I.D. #(s) <br /> E <br /> P TANK LINING REPAIR FEE=578.00/hour(3 hours TANK I.D.#(s) x S <br /> A m.^�nL �A�K) 5234 00 = <br /> I TAINK 1 .r.TROF1 f REPAIR FEE=S76/bour(3 hours mmtmumi-FACILITY)-5234 mir mum S <br /> PIPING REPAIR FEE=578.00/bour(3 hour minimum/FACILITY)=5234.00 minimum S <br /> M TRANSFER FEE=520.0071 UNAL>I HOR>7ED RELEASE EVALUATK)N= S <br /> I 578.00/br <br /> S CONSULTATION FEE=S78.00/hr SAMPLING=INSPECTION FEE=S78.00htr S <br /> C . AL DUE S 234 <br /> OFFICIAL USE ONLY <br /> SWEEPS# COMPUTER# LOC DIST AMOUNT CHECK#1 BRECENFD DATE RECEIVED <br /> CODE CODE <br /> EH 23 032(Revised 11-1-92) <br /> 11 <br />