Laserfiche WebLink
SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> I GROUND STORAGE TANK PROGRAM - FEE WORKSHEET <br /> F FACILITYISITE NAME FACILITY CONTACT NAME <br /> C Sierra Spring Water <br /> L STREET ADDRESS SITE PHONE (with Area Code) <br /> T 2477 N. Wig Wam, (800) 221 -1100 <br /> Y CITY Stockton., STATE IIP CODE t of TANK'S <br /> CA at Site l <br /> A APPLICANT/BILLING NAME APPLICANT CONTACT NAME <br /> P Hard Times REalty Barry Binning (916) 666-4141 <br /> P <br /> L 301 Monte Vista Woodland CA 95695 <br /> C MAILING ADDRESS 601 University Avenue, Suite 237 APPLICANT PHONE 1 (with Area Code) <br /> A <br /> N CITY Sacramento STATE IIP CODE TYPE of APPLICATION Tank <br /> T (Closure, Installation, et(.) Removal <br /> FACILITY FEE _ $100.00 each SITE ADDRESS per YEAR TOTAL <br /> A <br /> T 1986 1987 1988 1989 <br /> I $ <br /> V <br /> E TANK FEE _ $50.00 each TANK <br /> F 1 Tanks x (50.00 1986 1 1907 1 1988 1 1909 4Y <br /> A (multiply-I by fee far <br /> C each year applicable) R 8 <br /> f <br /> STATE SURCHARGE _ $56.00 each TANK (see CA HEALTH f SAFETY CODE Sec 25287 for applica <br /> T t Tanks x $56.001986 1987 1988 1989 FS <br /> Y (enter iiount and year) <br /> f <br /> C PERMANENT CLOSURE (Removal or Closure-in-place) <br /> L <br /> 5 CLOSURE FEE = 190.00 each TANK 1 Tanks ] x $90.00 f <br /> 90.00 <br /> U <br /> E TEMPORARY CLOSURE (Only allowed one time for up to two years) <br /> TEMPORARY CLOSURE FEE _ $80.00 each TANK 1 Tanks x $80.00 f <br /> PPLAN CHECK (Installation or Repair) <br /> LI <br /> A <br /> N PLAN CHECK FEE _ $30.00 each SUBMISSION/RESUBMISSION f <br /> R REPAIR <br /> EE TANK REPAIR FEE _ $110.00 each TANK t Tanks_ _ _ x (110.00 f <br /> A <br /> II PIPING REPAIR/CLOSURE/REMOVAL (Fees are per hour, minimum one hour to be paid on plan submittal) <br /> UNAUTHORIZED RELEASE EVALUATION CONSTRUCTION SAMPLING <br /> (when applicable) INSPECTION INSPECTION <br /> FEE = 130.00/hr FEE - f35.001hr FEE - $35.00/hr is <br /> TOTAL DUE f <br /> OFFICE USE ONLY <br /> SWEEPS 1 COMP 1 LOC CODE DIST CODE AMOUNT DUE AMOUNT RCVD CHECK /CASH RCVD BY I DATE RECEIVED PERMIT 1 <br /> �r 2H M1 90 e -to 3 Sl <br />