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SAN JnAQUIN COUNTY ENVIRONMENTAL HEALTH nFPARTMENT UNDERGRk,.dVD STORAGE TANK PROGRAM - _E WORKSHEET FACILITY NAME FACILITY CONTACT NAME Diesel Performance Fred Miner FACILITY ADDRESS SITE PHONE # WITH AREA CODE 2900 E Fremont 209 946-0233 CITY STATE ZIP CODE I # OF TANKS AT SITE Stockton 95208 CA 2 APPLICANT BILLING NAME I APPLICANT CONTACT NAME Diesel Performance Fred Miner APPLICANT MAILING ADDRESS APPLICANT PHONE # WITH AREA CODE P.O. Box 8387 209 946-0233 CITY STATE I ZIP CODE CIRCLE WORK TO BE DONE: Closun; Installation Repair Retrofit Stockton CA 95208-0387 ACTIVE FACILITY TANK ID # (s): CLOSURE FEE = $279 / TANK 1998 1999 2000 2001 2002 2003 $500 FEE INCLUDES FACILITY FEE +I TANK ($170) x(manks) ($170) X(#tanks) $ SAMPLING INSPECTION FEE = $ 93/ HOUR $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 =$24.00/ FACILITY PERMANENT CLOSURE Removal or Permitted Closure in Place TANK ID # (s): CLOSURE FEE = $279 / TANK # TANKS X $279 = TEMPORARYCLOSURE Plan Review and Inspections) TANK ID # (s) : TEMPORARY CLOSURE FEE = $279 / FACILITY Check and TANK ID PLAN CHECK FEE = �1 REPAIR PLAN CHECK TANK ID # (s): $ TANK RETROFIT REPAIR FEE = $279 / FACILITY use for monitoring equipment, spill buckets, tank sumps, misc. $ PIPING REPAIR FEE = $279 / FACILITY use for piping, under -dispenser containment, ect. $ MISCELLANEOUS $ TRANSFER FEE _ $ 20 $ CONSULTATION FEE = $ 93/ HOUR $ UNAUTHORIZED RELEASE EVALUATION FEE = $ 93 / HOUR $ SAMPLING INSPECTION FEE = $ 93/ HOUR ALL FEES ARE BASED ON THE $93 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. OFFICE USE ONLY