Laserfiche WebLink
SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />UNDERGROUND STORAGE TANK PROGRAM - FEE UORKSNEET <br />F <br />A <br />FACILITY SITE NAME <br />CAC l F /7/ &/1'61J Iq P p L <br />FACILITY CONTACT NAME <br />�T4 CK C 4 ,elf <br />1 <br />FACILITY ADDRESS <br />3 icJ, CSRA�r<�vE k <br />SITE PHONE IF with AREA CODE <br />ao9- s- �9zo <br />T <br />Y <br />CITY <br />7- C '>` - <br />STATEZIP <br />CODE <br />175374 <br />! of TANKS <br />at SITE <br />V <br />� <br />APPLICANT/BILLING MANE <br />- !� /9 % &x)/gxj GC <br />T CONTACT NAME <br />!C �S �i4Tff Ecce SUn/ <br />I <br />MAILING ADDRESSAPPLICANT <br />PHONE ! WITH AREA CODE <br />T <br />CITY ,,�1 �I <br />S N i �T A'e <br />�TAjE <br />(�/ <br />21P CODE `� <br />9 Sr <br />TYPE of APPLICATION <br />CLOSURE, INSTALLATION, <br />A <br />TOTAL <br />T <br />I <br />V <br />ANNUAL FACILITY FEE (Prior to January 1, 1991) S100.D0 <br />1986 1987 1988 1989 1990 <br />f <br />E <br />TANK FEE • $50.00/TANK (prior to January 1,1991) <br />$170/TANK (after January 1, 1991) <br />F <br />A <br />C <br />1 <br />! T"s <br />(multiply TW'fee }or <br />each year app •cable) <br />1986 1987 1988 1989 1990 <br />1991 1992 1993 1996 1995 1996 <br />S <br />ST11 ATE SURCHARGE • $56.00 each TANK (Due every 5 years) See California N i f Cote, Section 25287 <br />T <br />Y <br />! Tanks A (56.00 <br />(enter s>r mint and yell) <br />1986 through 1990 <br />1991 through 1996 <br />S <br />C <br />PERMANENT CLOSURE (Removal or Authorized Closure -in -Placa) <br />L <br />0 <br />CLOSURE FEE • $53.00 per hour (3 hours minimum per TANK) <br />! TAMK(s)_ X $159.00 <br />S <br />S <br />R <br />TEMPORARY CLOSURE (A one-time permit, for review/ Inspections) <br />TAMC I.D. JIM <br />E <br />TEMPORARY CLOSURE FEE • $150.00 each TANK <br />If TANK(*) X $150.00 <br />f <br />P <br />L <br />PLAN CHECK (Install. Pian Review 8 Construction Inspections) <br />TANK I.D. !(s) <br />A <br />N <br />PLAN CHECK FEE - S53.00 per hour (8 hours minimum per Facility) <br />• $424.00 alinia*p <br />S <br />R <br />E <br />REPAIR FEE (workplan review 8 construction inspections) <br />TAMC I.D. <br />P <br />A <br />TANK REPAIR FEE • $53.00 per hour (3 hours minimum/TANK) <br />! TAMK(s) L_ X $159.00 <br />S /5-5, <br />1 <br />R <br />PIPING REPAIR FEE • S53.00 per hour (3 hour minimum per facility • $159.00) <br />$ <br />Ml <br />I <br />TRANSFER FEE • $20.00 UNAUTHORIZED RELEASE EVALUATION • f53.D0/hr <br />f <br />S <br />ClCONSULTATION <br />FEE • $53.00/hr SAMPLING INSPECTION FEE <br />• $53.00/hr <br />S <br />TOTAL DUE <br />S/157 <br />EK Z3 032 (REV 4/8/91) it <br />