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I <br /> E=2 ism <br /> SAN JOAQU I N LOCAL HEALTH DISTRICT <br /> UkDERSROWD 51DRAGE TANK PROGRAM • FIE 8OIKSHEET <br /> C rAC1L1TY1S1rE NAME FACILITY CONTACT NAME <br /> Port of Stockton Aldo Freggiaro <br /> STREET ADDRESS 2201 W. Washington SITE PHONE 1 With Area Code) <br /> it - <br /> Y CITY Stockton, STATE IIP CODE 1 ai TANK'S <br /> CA at Site <br /> P APPLICAMTIDILLING 09E APPLICANT CONTACT NAME <br /> P Port of Stockton Aldo Freggiaro <br /> L <br /> CP.ADDRESS P. 0. Box 2089 APPLICANT PHNE 1 (with Area Code) <br /> A 249 946-0246 <br /> N City S1ATE IIP COPE TYPE of APPLICATION } e o7 e-excava on <br /> T Stockton, CA (Closure, Installation, etc.) work Plan <br /> A FACILirl FEE = 9100.00 each SITE ADDRESS per YEAR TOTAL <br /> ICA, <br /> 1986 1987 1988 1989 <br /> r , <br /> E IANK FEE _ $50.00 each TANK <br /> F 1 Tanks __ 150.00 N26 1987 Ilea 1939 <br /> A (eult(prj 1_Dy lee for <br /> C each year applicable) } <br /> 1 STATE SURCHARGE _ $56.00 each TANK (see CA HEALTH 1 SAFETY CODE Sec 25287 for applicability) <br /> T I Tanks x 156.00 1986 1981 19BB I9(19 <br /> Y (anter 4KA and year) <br /> i <br /> L PERMANEt1T CLOSURE {Removal or Closure-in-place) <br /> 5 CLOSURE FEE : $90.00 each TANK 1 Tanks _ r 190.00 ; <br /> U <br /> E TEMPORARY CLOSURE (Only alloyed one tier for up to two years) <br /> TEMPORARY CLOSURE FEE = 180,00 each TAAI( 1 Tanks a $60.00 ; <br /> FLAX CHECK (Installation or Repair) <br /> rN PLAN CHECK FEE _ $30,00 each SUBMISSION/RESUBMISS(DN $ <br /> REPAIR <br /> R <br /> EE TANK REPAIR FEE : 1110.00 each TANK 1 Tanks t $110.00 4 <br /> A <br /> IR PIPING REPAIR/CLOSURE/REMOVAL (Fees are per hcur, sinieue one hour to be paid on plan submittal) <br /> UNAUTHORIZED RELEASE EVALUATION CON5TROC110A Site/Sol SAMPLING <br /> When applicable) INSPECrIO r - x c a va i p INSPECTION <br /> FEE • 130.001hr FEE = 135,00/hr 35.0 FEE = 133.000, 315,00 $ 70.00 <br /> TOTAL DUE 1 <br /> OFFICE ISE Olt) <br /> REPS 1 COMP i lOC CODE DIST CODEAMOUNT DUE AMOUNT RCYD CHECK I/CASH RCVD ly OAIE RECEIVED PERAIT 1 <br /> a <br />