Laserfiche WebLink
SAN JOAQUIN COUN BLIC HEALTH SERVICES - ENVIRONMENTAL HEALY I0N <br />UNDERGROUND STORAGE TANK PROGRAM - FEE WORKSHEET <br />S <br />FACILITY SITE NAME <br />FACILITY CONTACT NAME <br />L <br />T <br />Arco Facilty # 548 <br />PLAN CHECK FEE = S78.00/hour (8 hours minimnVFACILITY) = $624.00 minimum ; <br />E <br />FACILITY ADDRESS <br />SITE PHONE # with AREA CODE <br />1612 West Harmer Lane <br />209 478-2723 <br />& <br />CITY <br />STATE <br />ZIP CODE <br /># of TANKS <br />A <br />Stockton <br />Ca. <br />195202 <br />at SITE <br />P <br />P <br />APPLICANT/BILLING NAME <br />APPLICANT CONTACT NAME <br />L <br />ARCO INC. <br />Rav Vose <br />I <br />C <br />MAILING ADDRESS <br />APPLICANT PHONE # WITH AREA CODE <br />A <br />P.O. Box 6411 <br />415 571-2469 <br />N <br />T <br />CITY STATE <br />ZIP CODE TYPE of APPLICATION <br />Artesia Ca. <br />P0702-6411 1 (Closure, Installation, etc.) <br />Repair <br />TOTAL <br />1986 1987 1988 1989 1990 <br />ANNUAL FACILITY FEE (Prior to January 1, 1991) = $100.00 <br />A <br />f <br />C <br />T <br />FACILITY PENALTY FEES ASSESSED (If Applicable) <br />XXXX XXXX <br />: <br />I <br />V <br />TANK FEE = S50.00/TANK (Prior to January 1,1991) <br />1170/TANK (After January 1, 1991) <br />E <br /># Tanks = 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 <br />F <br />(multiply # by fee for <br />A <br />each year applicable) <br />$ <br />C <br />I <br />TANK PENALTY FEES ASSESSED )XXX XXXX <br />5 <br />L <br />I <br />STATE SURCHARGE = $56.00 each TANK (Due every 5 years) See California H & S Code, Section 25287 <br />T <br />Y <br /># Tanks x $56.00 <br />1986 through 1990 <br />1991 through 1996 <br />(Enter amount and year) <br />S <br />C <br />PERMANENT CLOSURE (Removal or Authorized Ctosure-in-Ptace) <br />TANK I.D. #(s) <br />L <br />0 <br />CLOSURE FEE = 578.00/hour (3 hours minimm/TANK) <br /># TANK(s) X $234.00 = <br />f <br />S <br />U <br />TEMPORARY CLOSURE (Plan Review & Inspections) <br />TANK I.D. #(s) <br />R <br />E <br />I TEMPORARY CLOSURE FEE = 578.00/hour (3 hours minimum/FACILITY) = S234.00 minimum <br />5 <br />P <br />INSTALLATION PLAN CHECK (Plan Review & Construction Inspections) <br />L <br />A <br />N <br />PLAN CHECK FEE = S78.00/hour (8 hours minimnVFACILITY) = $624.00 minimum ; <br />M TRANSFER FEE = $20.00 UNAUTHORIZED RELEASE EVALUATION = $78.00/hr t <br />I <br />S <br />C CONSULTATION FEE = 578.00/hr SAMPLING INSPECTION FEE = S78.00/hr 5 , <br />TOTAL DUE <br />FOR OFFICE USE ONLY T <br />.... .... ...... .... ...... .... ...... :»Como:So»»oo»:�o«o»�o»o»;�o:;�a:»»»;««;wxo:»:: <br />90.10%=Wxw- .--------------------------------------- -- <br />EH 23 032 (REVISED 3-1-93) Paoe 11 <br />