Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> I ENVIRONMENTAL HEALTH DEPARTM J <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205-6232 <br /> Telephone:(209)468-3420 Far:(209)468-3433 Web:www.s'cehd.com <br /> BCE#10050-Installation <br /> FACILITY NAME FACILITY CONTACT NAME <br /> Costco Gasoline(Loc. No. 658) On-Duty Gasoline Facility Manager <br /> FACILITY ADDRESS SITE PHONE#WITH AREA CODE <br /> 3250 West Grant Line Road 209 830-5340 <br /> CITY STATE ZIP CODE 0 OF TANKS AT SITE <br /> Tracy CA 95377 3 existing+ 1 new=4 <br /> APPLICANT BILLING NAME APPLICANT CONTACT NAME <br /> Barghausen Consulting Engineers, Inc. Alexia Inigues, Project Planner <br /> APPLICANT MAILING ADDRESS APPLICANT PHONE#WITH AREA CODE <br /> 18215-72nd Avenue South If 425 251-6222 <br /> CITY STATE ZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC# <br /> -Kant Closure(Installation) Re air Retrofit I Out to Bid <br /> ACTIVE FACILITY <br /> $500 FEE INCLUDES FACILITY FEE+1 TANK(2007-2008) 2007 2008 2009 2010 2011 2012 <br /> $550 FEE INCLUDES FACILITY FEE+1 TANK(2009-2012) <br /> $125 PER TANK AFTER FIRST TANK $125 <br /> TANK PENALTY ASSESSED $ <br /> TANK SURCHARGE=$15/TANK $15 <br /> STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM=$49.00/FACILITY $ <br /> PERMANENTCLOSURE <br /> Removal or Permitted Closure In Place <br /> TANK I D#(s): CLOSURE FEE=$375/TANK #TANKS X$375= $ <br /> TEMPORARY CLOSURE <br /> Plan Review and Inspections) <br /> TANK ID#(s): TEMPORARY CLOSURE FEE_$375/FACILITY <br /> INSTALLATION PLAN CHECK <br /> Plan Check and Construction Inspections) <br /> TANK ID#(s): 4 PLAN CHECK FEE=$1000/FACILITY <br /> REPAIR PLAN CHECK <br /> TANK ID#(s): <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/FACILITY use for piping,under-dispenser containment ed. $ <br /> MISCELLANEOUS <br /> TRANSFER FEE _ $25 $ <br /> CONSULTATION FEE = $125/HOUR $ <br /> UNAUTHORIZED RELEASE EVALUATION FEE = $125/HOUR $ <br /> SAMPLING INSPECTION FEE = $125/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 $1,140 <br /> OFFICE USE ONLY <br /> SERVICE REQUEST# I FACILITY ID AMOU T RECEIVED CHECK# RECEIVED BY DATE RECEIVED <br /> S9_0b4 !G 5 $[O I I Vb 1 `N3, 80 <br /> EH 23 032(REVISED 04/13/12 by KF) <br />