Laserfiche WebLink
EM/IROM£NTAL HEALTH PAGE 01 <br /> ^ 08/21/2006 15:54 464013: SAN JOAQUI N COUNTY <br /> ENvU(ONMENTAL HEALTH DEPARTM65 f02 2 <br /> 304 East Weber Avenue.3-4 FIM.St 40ckmn,CA 33 Web_www-5 v. <br /> 708 <br /> Tclephene.(209)468-3420 For(P)Uo):(2D9) <br /> FACR.ITY ACT NAPE <br /> ACLLRY NAME <br /> a,h� 111 `ITEPHO v�� G � <br /> SITE PRONE S WITH <br /> FACILITY ADDRESS 33-�`�f7v�' <br /> 25- P CODE !OF TANKS AT SITE <br /> ✓ STATE <br /> CRY <br /> APPLICANT CONTACT NAME <br /> APPLICANT BILLING NAME // e(i Z7LC ve//m <br /> �D�?f�Q /'-S APPI.IC PHONE 9 VNTN AREA CODE <br /> APPLICANT MAIL�INNG�ADDRESS _ / &�-7 <br /> 9 ��� � C CLE WORK TO BE OWE/ �* <br /> CITYCSTATE LP C�OnDE�i <br /> 4 ' ��d"" CWW% YMebNon �ReP� ReYONI <br /> AcnvEFAauTY 1 2002 2003 2004 2005 2006 <br /> SWO FEE INCLUDES FACILITY FEE+1 TANK $ <br /> ;125 PER TANK AFTER FIRST TANK b <br /> 5 <br /> TANK PENALTY ASSESSED <br /> $ <br /> TANK SURCHARGE'$151 TA11C Dy ON p1VE•l4TORY IN A CUPA PROGRAM=(24-001 FACiL1TY <br /> STATE SLIRCNARGE FOR FAC UMS NOT ALREA <br /> R RMAN€a P ap CkWLNe in Piave a <br /> CLOSURE FEE=S?&5l7ANK 1TANKSXf285` <br /> TANK ID 1 5 <br /> TEMPORARY <br /> CLOSURE <br /> (Pian Review and <br /> TEMPORARY q.OSURE FEE z$286!FACILITY <br /> TANK ID 1(s): <br /> rN5 AL.LATION PLAN CHECK <br /> I Plan Check and ConspLANcHECKfFA=S760!FACILITY <br /> TANK ID 1(s) <br /> R PAIR PLAN CHECK <br /> TANK ID 1(51„____ _�'A to#aFc.�a,!at,s•A 3. 1- -- <br /> 285!FA 1-Y I�r n'g110d"g <br /> TANK RET'AOFIT�� <br /> $ +Xf taiynen!, <br /> use(o* ��—._. <br /> PIPING REPAIR FEE f285!FACILITY <br /> rFtANSFER FEE <br /> CONSULTATION FEE <br /> x FEF f 951 HOuFc g I <br /> EI-eASE EVALi1..TEON__ .... <br /> UNAUTI+ARIZEC RroAppLr,ANT..,.. ._ <br /> 3 99 HOUR .�FA®�Ya LSE L� <br /> SAMPLING INSPECTICI'I FEE - Y MTET l9(CE.Ds FEES <br /> :.yy FEE 5 AA��ow Tf�m ndR+1 "aA e .n'Ee�2 <br /> OFFICE 135E OFM.� al[cica _t�w-n�1° _ ,t - -- t <br /> SERVICE"MCO <br /> SR nraaoal <br /> Ell aeszavEVISED <br />