Laserfiche WebLink
SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> �IDERGROUND STORAGE TANK PROGRAM - FEE WORKS, <br /> F FACILITY/SITE NAME FACILITY CONTACT NAME <br /> A Charles E. Skobrak same <br /> C <br /> I <br /> L STREET ADDRESS-$15-f; P1iner Avenue SITE PHONE 1 (with Area Code) <br /> I <br /> T Yv r <br /> Y CITY Stockton STATE 21P CODE 1 of TANKS <br /> CA 95202 at Site 2 <br /> A APPLICANT/BILLING NAME APPLICANT CONTACT NAME <br /> P <br /> Charles E. Skobrak <br /> L <br /> I MAILING ADDRESS 706 N. E1 Dorado APPLICANT PHONE 1 (with Area Code) <br /> C (209) 465-2667 <br /> A <br /> N CITY STATE IIP CODE TYPE of APPLICATION Tank Removal <br /> T Stockton, CA 95202 (Closure, Installation, etc.) <br /> FACILITY FEE = 1100.00 each SITE ADDRESS per YEAR TOTAL <br /> A <br /> C 1986 1981 1988 1989 e? o <br /> T <br /> E TANK FEE = $50.00 each TANK <br /> F 1 Tanks A x 150.00 1986 1981 1988 1989 w.r <br /> A (multiply-1-by fee for <br /> C each year applicable) <br /> 1 aD Leop rp DU ^a 1 sff <br /> L STATE SURCHARGE = 156.00 each TANK (see CA HEALTH 1 SAFETY CODE Sec 25281 for applicability) <br /> I <br /> T 1 Tanks x 156.00 1986 1981 1988 1989 <br /> Y (enter amount and year) <br /> C PERMANENT CLOSURE (Removal or Closure-in-place) <br /> L 2 x $9o.0o f 180.00 <br /> 0 CLOSURE FEE = 190.00 each TANK 1 Tanks <br /> S <br /> U <br /> R TEMPORARY CLOSURE (Only allowed one time for up to two years) <br /> E <br /> TEMPORARY CLOSURE FEE = 180,00 each TANK 1 Tanks x $80.00 f <br /> P PLAN CHECK (Installation or Repair) <br /> L <br /> A <br /> N PLAN CHECK FEE _ $30.00 each SUBMISSION/RESUBMISSION 1 <br /> REPAIR <br /> P, <br /> E TANK REPAIR FEE = $110.00 each TANK 1 Tanks x 1110.00 f <br /> A <br /> I PIPING REPAIR/CLOSURE/REMOVAL (Fees are per hour, minimum one hour to be paid on plan submittal) <br /> R <br /> UNAUTHORIIED RELEASE EVALUATION CONSTRUCTION SAMPLING ti <br /> (when applicable) INSPECTION INSPECTION <br /> FEE = 130,00/hr FEE = 135.00lhr FEE = $35.00/hr ; t <br /> TOTAL DUE ' <br /> OFFICE USE ONLY r 33/ <br /> SWEEPS 1 COMP 1 LOC CODE DIST CODE I :AMOUNT DUE AHOUAT RCVD HE 1/CASH RCVD BY DATE RECEIVED PERMIT 1 <br /> 0 l 32 3 6 996° 57/Y7 -6) )o <br /> � u <br />