Laserfiche WebLink
SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone. (209) 468-3420 Fax: (209) 468-3433 Web: www.sj o� v.or /g ehd <br />FACILITY NAME <br />APPLICANT CONTACT NAME <br />FACILITY CONTACT NAME <br />\ <br />Qw�� <br />APPLICANT MAILING ADDRES&J <br />l <br />Y -A' C <br />FACILITY ADDRESS <br />�e `t3- wP6 <br />SITE PHONE # WITH AREA CODE <br />`Ssc) W <br />`fJr� S�- <br />SID 51- �S'00 <br />CITY <br />STATE <br />ZIP CODE OF TANKS AT SITE <br />' <br />CA <br />::,\S 36 b <br />APPLICANT BILLING NAME <br />APPLICANT CONTACT NAME <br />CLOSURE FEE = $294 / TANK <br />2003 <br />APPLICANT MAILING ADDRES&J <br />APPLICANT PHONE # WITH AREA CODE <br />D . <br />�e `t3- wP6 <br />CITY STATE <br />ZIP CODE CIRCLE WORK TO BE DONE <br />CONTRACTOR ICC # <br />W _ <�'C� t \ <br />CtS(,a Closure Installation Repair Retrofit <br />ACTIVE FACILITY <br />TANK ID # (s): <br />CLOSURE FEE = $294 / TANK <br />2003 <br />2004 <br />2005 <br />2006 <br />2007 <br />2008 <br />$500 FEE INCLUDES FACILITY FEE + 1 TANK (2002-2007) <br />PIPING REPAIR FEE = $294 / FACILITY use for piping, under -dispenser containment, eat. <br />UNAUTHORIZED RELEASE EVALUATION FEE _ $ 98 / HOUR <br />SAMPLING INSPECTION FEE _ $ 98/ HOUR "•" " <br />$550 FEE INCLUDES FACILITY FEE + 1 TANK (2008) <br />$125 PER TANK AFTER FIRST TANK <br />$ <br />TANK PENALTY ASSESSED <br />$ <br />TANK SURCHARGE = $15 / TANK <br />$ <br />STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM =$24.00/ FACILITY <br />PERMANENT CLOSURE <br />Removal or Permitted Closure in Place <br />TANK ID # (s): <br />CLOSURE FEE = $294 / TANK <br /># TANKS X $294 = <br />TEMPORARY CLOSURE <br />Plan Review and Inspections) <br />TANK ID # (s) : <br />TEMPORARY CLOSURE FEE _ $294 / FACILITY <br />TION PLAN CHEC <br />k and Construction <br />TANK ID # <br />CHECK FEE = $784 / F, <br />$ <br />.REPAIR PLAN CHECK <br />TANK ID # (s) : <br />$ <br />$ <br />TANK RETROFIT REPAIR FEE = $294 / FACILITY (us for monitoring equipment, cold starts, EVR upgrades, <br />s ill udcets, um s, misc. <br />CONSULTATION FEE _ $ 98/ HOUR <br />PIPING REPAIR FEE = $294 / FACILITY use for piping, under -dispenser containment, eat. <br />UNAUTHORIZED RELEASE EVALUATION FEE _ $ 98 / HOUR <br />MISCELLANEOUS <br />$ <br />TRANSFER FEE _ $ 20 <br />$ <br />CONSULTATION FEE _ $ 98/ HOUR <br />UNAUTHORIZED RELEASE EVALUATION FEE _ $ 98 / HOUR <br />SAMPLING INSPECTION FEE _ $ 98/ HOUR "•" " <br />ALL t==5 AK= 6FLJ=N VPI 1 n= y76 nUWMLi R 1-- <br />nnc nes, cw,..cvv . r...+..-.......--.... ...---- . - • - -•-• -- •- <br />