Laserfiche WebLink
I <br /> U 'U/ Tr/ SAN JOAOUIN COUNTY PUBLIC HEALTH SERVICES <br /> UNDERGROUND STORAGE TANK PROGRAM - FEE WORKSHEET <br /> FACILITY SITE NAME FACILITY CONTACT NAME <br /> V`1 A36 Q- STA i 1aruS <br /> I FACILITY ADDRESSSITE PHONE # with AREA CODE <br /> L <br /> I <br /> TCITY 1 � STATE ZIP CODE aN of t SITENKS <br /> A APPLICANT/BILLING NAME (•/Af— APPLICANT CONTACT NAME <br /> P <br /> P <br /> L <br /> I MAILING ADDRESS APPLICANT PHONE # WITH AREA CODE <br /> C <br /> A <br /> N CITY STATE ZIP CODE TYPE of APPLICATION <br /> T CLOSURE, INSTALLATION, etc. <br /> FACILITY FEE = 5100.00 each SITE ADDRESS per YEAR TOTAL <br /> A <br /> C 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 <br /> T <br /> I 10o iu� lou ?{xv Zoo 5 700 <br /> V ----d <br /> E TANK FEE = $50.00 each TANK So6TS <br /> F 9 Tanks AL x 550.00 1986 1987 1988 11989,11 0 1991 1 1992 1993 1 1994 1 1995 1996 <br /> A (multiply # by fee for <br /> C each year applicable) 2W 1 Zc<j -200 ¢ 5 , ao <br /> I <br /> L STATE SURCHARGE = $56.00 each TANK (see CA HEALTH 8 SAFETY CODE, Sec 25287 for applicability) <br /> I <br /> T # Tanks�K x 556.00 1986 1987 1988 1989 1990 1991 1 1992 1993 1994 1995 1996 <br /> Y (enter anoint and year) <br /> ZZ 1 1 1 1 1 1 1 1 1 $ Z2 <br /> PERMANENT CLOSURE (Removal or CLosure-in-place) <br /> C <br /> L CLOSURE FEE = $90.00 each TANK # Tanks x $90.00 S <br /> 0 <br /> S <br /> U TEMPORARY CLOSURE (Only allowed one time for up to two years) <br /> R <br /> E TEMPORARY CLOSURE FEE = $80.00 each TANK # Tanks x $90.00 $ <br /> P PLAN CHECK (Installation or Repair) <br /> L <br /> A <br /> N PLAN CHECK FEE = $30.00 each SUBMISSION/RESUBMISSION (1st 2 hrs. of review) $ <br /> REPAIR <br /> R TANK REPAIR FEE = $110.00 each SUBMISSION/RESUBMISSION # Tanks x $110.00 $ <br /> E <br /> P <br /> A PIPING REPAIR/CLOSURE/REMOVAL (Fees are per hour, minimus one hour to be paid on plan submittal) <br /> I <br /> R UNAUTHORIZED RELEASE EVALUATION CONSTRUCTION INSPECTION SAMPLING INSPECTION <br /> (when applicable) (when applicable) (when applicable) <br /> FEE = 530.00/hr FEE = $35.00/hr FEE = $35.00/hr $ <br /> GS WQ�-2 D+F3 .aaQ �j(..)CI LIQ TOTAL DUE $ <br /> V 1`169 K 1550 . <br /> OFFICE USE ONLY AM UtJAt QCT = LI 20FS LI Cl ql�'(.J 0.(..IG�L „...................................................... <br /> _.......p................ . .................. ..p..................................................................................... ................................- ....... .. .. p_ __ .a <br /> �=•exeemzo.zo.n.e. »» � NT ��P <br /> a <br /> a <br /> » 5 » <br /> FH 23 032 (REV 6/90) It <br />