COMPLIANCE INFO_2005-2009 - Laserfiche WebLink

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. SAN JOAQUIN COUNTY 0 ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone. (209) 468-3420 Fax: (209) 468-3433 Web: www.sjjzov.orgJehd FACILITY NAME FACILITY CONTACT NAME 6011- Sr®� � / SZ, 4 (, T—" 5-k (' ► a K M'(LqqG FACILITY ADDRESS SITE PHONE # WITH AREA CODE oaf - 1-4-Z( S. 69 - 2007 CITY CITY STATE ZIP CODE # OF TANKS AT SITE Gob CA 9 5�-2�(o 3 APPLICANT BILLING NAME TANK ID # (s): APPLICANT CONTACT NAME 4 (, T—" 5-k (' ► a K M'(LqqG C • % UI (C bi A-&-1UTA'(/%-4 APPLICANT MAILING ADDRESS 2007 APPLICANT PHONE #WITH AREA CODE P.0, lr>0 X (oif $500 FEE INCLUDES FACILITY FEE + 1 TANK (2002-2007) 116 -1-4-3- i(s2-- CITY STATE ZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC # SAMPLING INSPECTION FEE = $ 98/ HOUR C A- CIY6 -1 ( Closure Installation Repai etrofit ACTIVE FACILITY TANK ID # (s): CLOSURE FEE = $294 / TANK 2003 2004 2005 2006 2007 2008 $500 FEE INCLUDES FACILITY FEE + 1 TANK (2002-2007) $ PIPING REPAIR FEE = $294 / FACILITY use for piping, under -dispenser containment, ect. $ SAMPLING INSPECTION FEE = $ 98/ HOUR $550 FEE INCLUDES FACILITY FEE + 1 TANK (2008) $ $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 =$24.00/ FACILITY PERMANENT CLOSURE Removal or Permitted Closure in Place TANK ID # (s): CLOSURE FEE = $294 / TANK # TANKS X $294 = TEMPORARY CLOSURE Plan Review and Inspections) TANK ID # (s) : TEMPORARY CLOSURE FEE = $294 / FACILITY and Construction TANK ID # (s) : I PLAN CHECK FEE = $784 / FACILITY .REPAIR PLAN CHECK TANK ID # (s) : $ TRANSFER FEE _ $ 20 $ TANK RETROFIT REPAIR FEE = $294 / FACILITY (use for monitoring equipme ,cold starts VR upgrades, % spill buckets, sumps, misc. $ PIPING REPAIR FEE = $294 / FACILITY use for piping, under -dispenser containment, ect. MISCELLANEOUS $ TRANSFER FEE _ $ 20 $ CONSULTATION FEE = $ 98/ HOUR $ UNAUTHORIZED RELEASE EVALUATION FEE = $ 981 HOUR $ SAMPLING INSPECTION FEE = $ 98/ HOUR ALL FEES ARE BASED ON THE $98 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. OFFICE USE ONLY SERVICE REQUEST # FACILITY ID AMOUNT RECEIVED CHECK # RECEIVED BY DATE RECEIVED SIR EH 23 032 (REVISED 12/31/07)