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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.sigov. ort/ehd FACILITY NAME FACILITY CONTACT NAME Manteca Cruisers Monica Farhat FACILITY ADDRESS SITE PHONE # WITH AREA CODE 1137 W Lathrop Rd 209-8 4-2760 CITY STATE ZIP CODE I # OF TANKS AT SITE Manteca CA 95336 3 APPLICANT BILLING NAME APPLICANT. CONTACT NAME Able Maintenance Inc Marty Weithman APPLICANT MAILING ADDRESS APPLICANT PHONE #WITH AREA CODE 680 Quinn Ave . 408- 213-6038 CITY STATE ZIP CODE CIRCLE WORK TO BE BONE CONTRACTOR ICC # [ San Jose CA 95112 � 5250610 ACTIVE FACILITY $500 FEE INCLUDES FACILITY FEE + 1 TANK (2003-2008) 2004 2005 2006 2007 2008 2009 $550 FEE INCLUDES FACILITY FEE + 1 TANK (2009) $ 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 a00/ $ PERMANENT CLOSURE Removal or Permitted Closure in Place TANK ID # (s) : CLOSURE FEE = $315 / TANK # TANKS X $315 = $ TEMPORARY CLOSURE Plan Review and Inspections) TANK ID # (s) : TEMPORARY CLOSURE FEE _ $315 / FACILITY $ INSTALLATION PLAN CHECK Plan Check and Construction Inspections ) TANK ! D # (s) : PLAN CHECK FEE _ $840 / FACILITY $ REPAIR PLAN CHECK TANK ID # (s) : TANK RETROFIT REPAIR FEE _ $315 ! FACILITY (use for monitoring equipment, cold starts, EVR upgrades, $ 684 spill buckets sumps , misc. PIPING REPAIR FEE _ $315 / FACILITY use for piping, under-dispenser containment, act. $ MISCELLANEOUS TRANSFER FEE _ $ 20 $ CONSULTATION FEE = $ 105/ HOUR $ UNAUTHORIZED RELEASE EVALUATION FEE _ $ 105 / HOUR $ SAMPLING INSPECTION FEE _ $ 105/ HOUR $ ALL FEES ARE BASED ON THE 5105 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. OFFICE USE ONLY SIRESERVICE FACILITY ID AMOUNT RECEIVED CHECK # RECEIVED BY= RECEIVEp SIR EH 23 032 (REVISED 02/23109)