Laserfiche WebLink
SAN J UIN COUNTY ENVIRONMENTAL HEALTH CAJRTMENT <br />UNDERGR D STORAGE TANK PROGRAM PWWORKSHEET <br />1111111 -TA 11111 ed 11 Elf, <br />APPLICANT CONTACT NAME <br />ELITE IV CONTRACTORS, INC. <br />FACILITY-7CONTACT NAME <br />APPLICANT MAILING ADDRESS <br />APPLICANT PHONE # WITH AREA CODE <br />2535 WIGWAM DRIVE <br />(209) 461-6337 <br />CITY I STATE <br />ZIP CODE <br />CIRCLE WORK TO BE DONE: <br />Closure Installation Repair Retrofit <br />STOCKTON L CA <br />95 205 <br />SITE PHONE # WITH AREA CO E 7 <br />-,Ila n-[,-,eview and Inspections) <br />RUN <br />ANK PENALTY ASSESSED <br />(s): <br />TEMPORARY CLOSURE FEE = $279 /FACILITY <br />$ <br />ANK SURCHARGE= $10 /TANK <br />$ <br />,;TAT-~ SURCHARGE FOR FACILITIES NOT ALREADY ON INVL,,,'1,-ORy IN A CUPA PROi�,';Alvl 417.50/ FACILITY <br />APPLICANT BILLING NAME <br />APPLICANT CONTACT NAME <br />ELITE IV CONTRACTORS, INC. <br />CARRIE MILLER <br />APPLICANT MAILING ADDRESS <br />APPLICANT PHONE # WITH AREA CODE <br />2535 WIGWAM DRIVE <br />(209) 461-6337 <br />CITY I STATE <br />ZIP CODE <br />CIRCLE WORK TO BE DONE: <br />Closure Installation Repair Retrofit <br />STOCKTON L CA <br />95 205 <br />ACTIVE FACILITY <br />$500 FEE INCLUDES FACILITY FEE + 1 TANK <br />$125 PER TANK AFTER FIRST TANK <br />1998 <br />($170) X (#tanks) <br />1999 <br />(S1 70) X (#tanks) <br />2000 <br />2001 <br />2002 <br />2003 <br />CLOSURE FEE= $279 /TANK <br /># TANKS X $279 = <br />TEMPORARY CLOSURE <br />-,Ila n-[,-,eview and Inspections) <br />$ <br />ANK PENALTY ASSESSED <br />(s): <br />TEMPORARY CLOSURE FEE = $279 /FACILITY <br />$ <br />ANK SURCHARGE= $10 /TANK <br />$ <br />,;TAT-~ SURCHARGE FOR FACILITIES NOT ALREADY ON INVL,,,'1,-ORy IN A CUPA PROi�,';Alvl 417.50/ FACILITY <br />PERM ANENT CLOSURE <br />(Removal or Permitted Closure in Place) <br />$ <br />TANK ID # (s): <br />CLOSURE FEE= $279 /TANK <br /># TANKS X $279 = <br />TEMPORARY CLOSURE <br />-,Ila n-[,-,eview and Inspections) <br />(s): <br />TEMPORARY CLOSURE FEE = $279 /FACILITY <br />ffiTf A�, LAT-16—NP. i. -N - CHECK <br />— <br />;Piao, ieck and Gor.6L,-Uc-fion�SesbLor!s-)- <br />TANIo' 0 # (s): <br />PLAN CHECK FEE = $744 / FA(IUTY <br />A <br />(s) <br />TANK RETROFIT REPAIR FEE S $279 1 FACII 7Y (use for monitoring equipment, spill buckets, tank sumps, misc.) $ <br />PIPING REPAIR FEE = $279 / FACILITY (use for piping, unoer-dispenser containment, ect) $ <br />TRANSFER FEE $20 <br />CONSULTATION FEE $ 931 HOUR <br />.AAUTHORIZED RELEASE EVALUATION Fr=E = $ 93 I'HOUR <br />SAMPLING INSPECTION FEE $ 931 HOUR <br />ALL FEES ARE BASED ON THE $93 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE <br />OFFICE USE ONLY <br />2 <br />