Laserfiche WebLink
SAID JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.ory/ehd <br />FACILITY NAME FACILITY CONTACT NAME <br />COSTCO GASOLINE LOC. NO. 1031 JULIAN OCHOA, GAS STATION SUPERVISOR <br />FACILITY ADDRESS 51TE PHONE # WITH AREA CODE <br />2440 DANIEL 209 825-8200 <br />CITY STATE ZIP CODE # OF TANKS AT SITE <br />MANTECA r o 95336 THREE (3) <br />APPLICANT BILLING NAME <br />COSTCO WHOLESALE CORPORATION DENNIS BOCK <br />APPLICANT MAILING ADORES5 APPLICANT PHONE # WITH AREA CODE <br />999 LAKE DRIVE 425 313-8100 <br />CITY STATE ZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC # <br />520551•UT & 5311530 -UT <br />ISSAQUAH WA 98027 Closure Installation Repair Retrofit 52Q561 -u1 & 531153au1 <br />ACTIVE FACILITY <br />2004 2005 2006 2007 2008 2009 <br />$500 FEE INCLUDES FACILITY FEE + 1 TANK (2004-2007) <br />$550 FEE INCLUDES FACILITY FEE + 1 TANK (2008-2009) $ <br />$125 PER TANK AFTER FIRST TANK <br />TANK PENALTY ASSESSED $ <br />TANK SURCHARGE = $15! TANK $ <br />STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM =$49.001 FACILITY <br />PERMANENT CLOSURE <br />Removal or Permitted Closure in Place $ <br />TANK ID # (s) : CLOSURE FEE _ $345 ITANK # TANKS X $345 = <br />Plan Review and inspections) $ <br />TANK ID # (s) : I TEMPORARY CLOSURE FEE = $345 1 FACILITY <br />INSTALLATION PLAN CHECK <br />Plan Check and Construction Inspections) $ <br />TANK ID # (s) : PLAN CHECK FEE= $920 /FACILITY <br />REPAIR PLAN CHECK <br />TANK ID # (s) : <br />TANK RETROFIT REPAIR FEE = $3451 FACILITY (use for monitoring equipment, cold starts, EVR upgrades,. <br />spill buckets, sumps, mise. <br />$ <br />PIPING REPAIR FEE = $345 / FACILITY use for piping, under -dispenser containment, ect. <br />OFFICE USE ONLY <br />SERVICE REQUEST # FACILITY ID <br />SR <br />EH 23 032 (REVISED 07101109) <br />