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�- SAN JOAQUIN COUNTY v' <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.or;;fehd <br /> FACILITY NAME FACILITY CONTACT NAME <br /> River Point Landing Marina Resort Andrew Rehberg <br /> FACILITY ADDRESS SITE PHONE#WITH AREA CODE_ <br /> 4950 Buckley Cove Way 209 951-4144 <br /> CITY F STATE ZIP CODE #OF TANKS AT SITE <br /> btocKton CA <br /> APPLICANT BILLING NAME APPLICANT CONTACT NAME <br /> Fillner Construction, Inc Jeff Scott <br /> APPLICANT MAILING ADDRESS APPLICANT PHONE#WITH AREA CODE <br /> 4470 Yankee Hill Rd., Suite 200 916 624-1985 <br /> CITY STATE ZIP CODE CIRCLE WORK NE CONTRACTOR ICC# <br /> Rocklin Closure Installation a airetrofrt <br /> ACTIVE FACILITY <br /> 2006 2007 2008 2009 2010 2011 <br /> $500 FEE INCLUDES FACILITY FEE+ 1 TANK(2006-2007) <br /> $550 FEE INCLUDES FACILITY FEE+ 1 TANK(200$-2011) <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=$49.00!FACILITY $ <br /> PERMANENT CLOSURE NA <br /> Removaf or Permitted Closure in Place) <br /> TANK ID#(s): CLOSURE FEE=$3751 TANK #TANKS X$375= <br /> TEMPORARY CLOSURE <br /> Plan Review and Inspections) <br /> TANK ID#(s): TEMPORARY CLOSURE FEE_$3751 FACILITY <br /> INSTALLATION PLAN CHECK <br /> Plan Check and Construction Inspections) <br /> TANK ID#(s): NA PLAN CHECK FEE=$1,0001 FACILITY <br /> REPAIR PLAN CHECK <br /> TANK ID#(S): DieSel TA0102806 <br /> TANK RETROFIT REPAIR FEE =$375/FACILITY (use for monitoring equipment,cold starts,EVR upgrades, <br /> spill buckets,sumps,misc. <br /> PIPING REPAIR FEE=$375 1 FACILITY (use for piping,under-dispenser containment,ect.) <br /> MISCELLANEOUS <br /> TRANSFER FEE _ $25 $ <br /> CONSULTATION FEE _ $ 1251 HOUR $ <br /> UNAUTHORIZED RELEASE EVALUATION FEE = $ 125/HOUR $ <br /> SAMPLING INSPECTION FEE = $ 1251 HOUR $ <br /> ALL FEES ARE BASED ON THE$125 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. <br /> TOTAL AMOUNT DUE $ <br /> OFFICE USE ONLY <br /> SERVICE REQUEST# FACILITY 10 AMOUNT RECEIVED CHECK# RECEIVED BY DATE RECEIVED <br /> EH 23 032(REVISED 0811/11 by KF) <br />