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I <br /> UNDERGROUND STORAGE 1AR9 PROGRAM IRR MUMkaattl <br /> S 9 ACItlIY 9111 RAW 1AC41.11r CONIACI NMI <br /> 1 Valley Wholesale Drug Co. , Inc Paul Souva <br /> 1 <br /> E fAcilif1l ADDRESS 1401 W. fremont St. 6119 PHONE I with AREA CCDE (209)/166-0131 <br /> it <br /> CIIY f1Alt JIIP rrOE I o! 1ANKf <br /> A Lodi, CA Q5203 at Solt 2 <br /> P <br /> P APPLICANT/111LLIN0 UM* APPIICANI CONIACT NAME <br /> L Valley Wholesale Drug, Inc. Paul Souva <br /> 1 <br /> C 11AMINQ ADDRESS APPl1CAN1 POICNE N WIN AREA CODE <br /> A P.O. Box 2065 (209)466-0131 <br /> N <br /> I CITY SIAIE IIP rrDE ITPE of APPtICAIION <br /> Stockt011 Ic 201 (Closure, Installation, etc > fle[IIUVat <br /> MAI <br /> 6996 19N/ 1988 1999 1990 <br /> ANIAMI. FAClllir FEE (Prior to Jnruary 1, 19911 ■ 1100 40 <br /> A 1 <br /> C <br /> 1 IACIt11Y PENAIIT FEES ASSESSED (If Applicable) XXXX XXXX f <br /> 1 <br /> V WANK FEE + ISO 00/IANK (Prior to January 1,1991) 6110/IANK (After January 1, 1991) <br /> E <br /> N lanks 1996 1967 19!!6 1999 1990 1991 1992 1993 1994 1995 1996 <br /> F fmail tlply I-Gy fee for <br /> A each year arpllcable) f <br /> I IANK VIMAIIV FEES ASSESSED XXXX XXXX 1 <br /> L <br /> 1 SIAIE SURCIIARGE ■ 836 00 each IANK (Due every S years) See California R t S Code. Section 23207 <br /> 1 <br /> 1 N tanks R 156 00 1966 through 1990 1991 through 1996 <br /> linter amount and year) <br /> s <br /> r PERNANIMI CIOMME (Removal or Authorized Closure In Place) IANX 1 0 ifs) �a <br /> l <br /> r 0 CLOSURE fit ■ 179 00/hour 43 hours ainhum/!Aust) I IANK(s) 2 X 6234 00 146$.009? <br /> S <br /> U 1111PORANY CLOSURE fPlan Review t Inspections) IANK I D 10) <br /> R <br /> E IEIIPORART CIOSURE FEE ■ 118 00/hour 43 hours a Ainlaxre/fAC11.11V) 1234 O0 alnleam t <br /> P IHSIAltAl10N PLAN CNECK (Plan Review 9 Conslrucllon Impecllons) IANK 1 0 1(s) <br /> I. <br /> A <br /> N PLAN CHECK FEE ■ 176 00/hour 16 hours minlomoWfACIt11Y) * $624 00 minteasa 1 <br /> R REPAIR fit (Uorkptsn Ravlem It CorAslructlon Iroptctlons) WANK 1 0 1(a) <br /> E <br /> r IANK tiNIH0 REPAIR fit ■ 116 00/hour 43 hours ainletsa/oANK) 1 IANKIs) X 1234 00 f <br /> A <br /> 1 WANK REIROfII REPAIR fit ■ 176 00/hour (3 hours spin /fACltlll) ■ 5234 00 w(nleara S <br /> It <br /> PIPING REPAIR IEE ■ 176 00/hour 43 hours nlnleefi/FACIIIIV) ■ 1234 00 minleue $ <br /> H IRANSFER IEE ■ S20 00 4RIAUIIla111JED RELEASE EVAMAIIM ■ 178 00/hr 1 <br /> 1 — <br /> S <br /> C MISIFLIA11011 FEE it 118 00/hr SAMPLING INSPEeIM FEE ■ 118 00/hr ! <br /> IOIAI OUE f <br /> QQ <br /> R OFFICE USE ONtr <br /> w w.i aw M.:nwa a.M•.ri C.i Mwi aw Mwi ewi iw Mn.�a:.M.a:M..w.w wi ala aa..M�..�w.+i ww ww.i a•M w...i•.i aM.Ma.M�.M M�:...:w M.i iwwi MN w■r:.i Miw aM.M.ai iw ani n...i Mi M <br /> 9 s1 f11'sr''l m �yes7i��1AT7 �rr"�`d�a Ar'li�'Asrl"'elFfl'E'"" �1MfftrMMrt'� r '�'�.1�"�'1�`if IC' OTIE �1E`�"�Y"ae." '"1f1CY"rA7nY11r"'"" i <br /> 6 <br /> MW INaa..i AWN 0"MMM."W am MM M•AMW MW MTM mow.MWA~"wM MM MTM M1.MMOMww■MM M alrwowawlom M■wM..Ilial"M■iw AA--MM <br /> eL L a Ike W Ra■AM MeM�AA"IA■M■e mom la"Ma"AA"aey"!M rA"Maw IMA dAAe"i"M"e r"IAN 1gAe Mf Mw AA"MTM n"MW Me MOM Me AMM 1Ma eMM Ma AM AIMe rile rMAa AW AWMI rAe AMA■M"!"rMMr Mr ON <br /> EN 21 O31 /REVISED 1 1 911 Paco 11 <br />