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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.sjgov.org/ehd FACILITY NAME FACILITY CONTACT NAME Valley Pacific Petroleum - Charter Way Cardlock Mike Eliason FACILITY ADDRESS SITE PHONE # WITH AREA CODE 1501 W Charter Way 209 993-8793 CITY I STATE ZIP CODE I # OF TANKS AT SITE Stockton CA 95206 2 APPLICANT BILLING NAME APPLICANT CONTACT NAME Valley Pacific Petroleum Services Mike Eliason APPLICANT MAILING ADDRESS APPLICANT PHONE # WITH AREA CODE 188 A Frank West Circle 209 993-8793 CITY StoCkton STATE I CA ZIP CODE CIRCLE WORK TO BE DONE 95206 Closure Installabo Repair Retrofit CONTRACTOR ICC # ACTIVE FACILITY 2005 2006 2007 2008 2009 2010- $500 FEE INCLUDES FACILITY FEE + 1 TANK (2005-2007) $550 FEE INCLUDES FACILITY FEE + 1 TANK (2006-2010) $ $125 PER TANK AFTER FIRST TANK TANK PENALTY ASSESSED TANK SURCHARGE = $15 / TANK STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM =$49.00/ FACILITY PERMANENT CLOSURE Removal or Permitted Closure in Place TANK ID # (s): CLOSURE FEE = $366 / TANK # TANKS X $366 = TEMPORARY CLOSURE Plan Review and Inspections) TANK ID # (s) : TEMPORARY CLOSURE FEE _ $366 / FACILITY INSTALLATION PLAN CHECK Plan Check and Construction Ins ections TANK ID # (s) : PLAN CHECK FEE _ $976 / FACILITY REPAIR PLAN CHECK TANK ID # (s) : TANK RETROFIT REPAIR FEE = $366 / FACILITY (use for monitoring equipment, cold starts, EVR upgrades, 366 spill buckets, sums misc. PIPING REPAIR FEE = $366 / FACILITY use for piping, under -dispenser containment, act. MISCELLANEOUS ALL FEES ARE BASED ON THE $122 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. TRANSFER FEE _ $ 25 CONSULTATION FEE _ $ 122/ HOUR UNAUTHORIZED RELEASE EVALUATION FEE = $ 122 / HOUR SAMPLING INSPECTION FEE _ $ 122/ HOUR ALL FEES ARE BASED ON THE $122 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT.