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SAN JOAOUIN COUNTY PUBLIC HEALTN SERVICES - ENVIRONMENTAL HEALTH DIVSION IAD- -RAND STORAGE TANK PROGRAM - FEE WORKSHEET S I FACILITY SITE NAME FACILITY CONtWf NAME 1987 1988 1989 T E FACILITY ADDRESS SITE PHONE N with AREA CODE 45 O E Fer.7tzvpwr 51 209 - q48 ' 8/ 7 $ A CITY CA/ZIP CODE _ A of TANKS SI QC' CA "I`52r� et SITE 4 P TANK LINING REPAIR FEE _ !78.00/hour (3 hours minimuOTANK) P P APPLICANT/BILLING NAME APPLICANT CONTACT NAME tE NI �T�V I LEO AP -1 l5P C NAILING ADDRESS # APPLICANT PHONE A WITH AREA CODE A 'L-735TEEiE tJ2. TE E Zv - r 2<4 R . IT I CITY 0 TANK(s)_ K $234.00 - ZIP CODE rr)) TYPE of APPLICATION G� Er/I L L/,4 L C T i / To nSTnATE CA (Closure, Installation, etc.) TOTAL C PERMANENT CLOSURE (Removal or Authorized Closure- in -Place) 1986 1987 1988 1989 1990 CLOSURE FEE _ $78.00/hour (3 hours minimum/TANK) N TANK(s)-4— K $234.00 = ANNUAL FACILITY FEE (Prior to January 1, 1991) - $100.00 P TANK LINING REPAIR FEE _ !78.00/hour (3 hours minimuOTANK) N PLAN CHECK FEE _ $78.00/hour (8 hours minimum/FACILITY) 9624.00 minimum S A U KNNK KKKK R I TANK RETROFIT REPAIR FEE _ $78.00/hour (3 hours min./FACILITY) _ $234.00 minimus f R E TEMPORARY CLOSURE FEE - 1178.00/hour (3 hours minimum/TANK) 0 TANK(s)_ K $234.00 - f PIPING REPAIR FEE _ $78.00/hour (3 hours minimun/FACILITY) _ &234.00 mini" C T FACILITY PENALTY FEES ASSESSED (If Applicable) KKKK KKKN $ I V TANK FEE _ $50.00/TANK (Prior to January 1,1991) $170/1ANK (After January 1, 1991) E R Tanks 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 F (multiply 0 by fee for KKKK KKKK S A each year applicable) C 1 TANK PENALTY FEES ASSESSED KKKK KKKK & L 1 STATE SURCHARGE - 556.00 each TANK (Due every 5 years) See California N $ S Code, Section 25287 T Y R Tanks A $56.00 1988 through 1990 1991 through 1996 (Enter amount erd year) f C PERMANENT CLOSURE (Removal or Authorized Closure- in -Place) TANK I.D. N(a) L L 0 CLOSURE FEE _ $78.00/hour (3 hours minimum/TANK) N TANK(s)-4— K $234.00 = A P TANK LINING REPAIR FEE _ !78.00/hour (3 hours minimuOTANK) N PLAN CHECK FEE _ $78.00/hour (8 hours minimum/FACILITY) 9624.00 minimum S U TEMPORARY CLOSURE (Plan Review & Inspections) TANK I.D. R(a) R I TANK RETROFIT REPAIR FEE _ $78.00/hour (3 hours min./FACILITY) _ $234.00 minimus $ R E TEMPORARY CLOSURE FEE - 1178.00/hour (3 hours minimum/TANK) 0 TANK(s)_ K $234.00 - f P INSTALLATION PLAN CHECK (Plan Review & Construction Inspections) TANK I.D. M(a) L A P TANK LINING REPAIR FEE _ !78.00/hour (3 hours minimuOTANK) N PLAN CHECK FEE _ $78.00/hour (8 hours minimum/FACILITY) 9624.00 minimum f R REPAIR FEE (Workplan Review E Construction Inspections) TANK I.D. N(a) E P TANK LINING REPAIR FEE _ !78.00/hour (3 hours minimuOTANK) R TANK(s) K $234.00 = S A I TANK RETROFIT REPAIR FEE _ $78.00/hour (3 hours min./FACILITY) _ $234.00 minimus $ R PIPING REPAIR FEE _ $78.00/hour (3 hours minimun/FACILITY) _ &234.00 mini" S NI TRANSFER FEE = 520.00 , CONSULTATION FEE _ 178.00/hr FOR OFFICE USE ONLY UNAUTHORIZED RELEASE EVALUATION - $78.00/hr f SAMPLING INSPECTION FEE = 578.00/hr f TOTAL DUE CI EN 23 032 (REVISED 6-21-93) Page 11