Laserfiche WebLink
Dec 07 10 01:49p Reliable Petrole <br />209-845-8953 p.11 <br />0 <br />SAN JOAQUIN COUNTY <br />ENVIRONMEN`T'AL HEALTI-I MPAR"I TENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax. (209) 468-3433 We& www.si ov.or ehd <br />FACILITY NAPA <br />FACILITY CONTACT NAIVE <br />- 5-b C) <br />,K if V-/'ri ttr <br />FACILITY ADOR SS <br />SITE PHONE # WITH AREA CODE <br />CITY STATE <br />ZIP CODE # OF TANKS AT SITE <br />G � CA <br />9 5 3 3 to .5 <br />APPLICANT BI LI.ING NAME <br />APPLICANT CONTACT NAME <br />SerV } c -es <br />APPLICANT MAI IVIG ADDRESS <br />C, Rb berfu v,n ��a r� <br />APPLICANT PHONE # WITH AREA CODE <br />1 I q OC.d <br />q) es g(.e <br />CITY <br />STATE <br />ZIP CODE <br />CIRCLE WORK TO BE DONE <br />CONTRACTOR ICC # <br />Closure Inslallat- Repafr. Retrofit <br />52- LCJ-CI O <br />ACTIVE FACILI <br />TANK ID # s CLOSURE FEE TANKS X $366 = <br />TEMPORARY CLC PSURE <br />$500 FEE INCLUE <br />$550 FEE INCLUE <br />$125 PER TANK A <br />ES FACILITY FEE + 1 TANK (2005-2007) <br />ES FACILITY FEE + 1 TANK <br />FTER FIRST TANK <br />2005 <br />2006 <br />2007 <br />2008 <br />2009 <br />2010 <br />$ <br />TANK PENALTY ASSESSED <br />TANK SURCHAR E = $151 TANK <br />$ <br />STATE SURCHARGE <br />FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM =$49.001 FACILITY <br />$ <br />PERMANENT CL URE <br />(Removal or Permi ed Closure in Place <br />TANK ID # s CLOSURE FEE TANKS X $366 = <br />TEMPORARY CLC PSURE <br />Plan Review and Ii Ispections) <br />TANK ID # (s) : I <br />TEMPORARY CLOSURE FEE = $365 / FACILITY <br />Check and <br />TANK ID#(s): <br />PLAN CHECK FEE = <br />REPAIR PLAN CH CK <br />TANK ID # (s) : <br />TANK RETROFIT EPAIR FEE = $3661 FACILITY (use for moritoring equipment, cold starts. EVR upgrades, <br />s ib txu�cets, sum s, mist. <br />$ <br />PIPING REPAIR F E = $366 / FACILITY use for piping, under -dispenser containment, ect.) <br />2 1_ <br />$ 3 �'(L'• <br />MISCELLANEOUS <br />TRANSFER FEE _ $ 25 <br />$ <br />CONSULTATION FEE = $ 1221 HOUR <br />$ <br />UNAUTHORIZED R aEASE EVALUATION FEE = $ 1221 HOUR <br />$ <br />SAMPLING INSPECTION FEE = $ 1221 HOUR <br />ALL FFFS ARF RfiAtP nm Tm= cl�� a .w -- _ _ _. <br />$ <br />