Laserfiche WebLink
9255517888 Line 09:27:09 04-20-2015 7/10 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT r <br /> 600 East Main Street, Stockton,CA 95202-3029 EG E I YE E,' <br /> Telephone:(209)468-3420 Fax: (209)468-3433 Web:www.si;ov.org/ehd <br /> FACILITY NAME FACILITY CONTACT NAME 5 <br /> 8363464 <br /> r— <br /> FACILITY ADDRESS SITE PHONE#WITH AREA CODE I IVIVIVICWA <br /> 2615 West Grantline Road 408 636-6651 <br /> CITY STATE ZIP CODE #OF TANKS AT SITE <br /> Tracy CA 95304 <br /> APPLICANT BILLING NAME APPLICANT CONTACT NAME <br /> Gettler Ryan Inc. LIDDY MCKENZIE <br /> APPLICANT MAILING ADDRESS APPLICANT PHONE#WITH AREA CODE <br /> 6805 Sierra Court,Suite G 408 636-6651 <br /> CITY STATEZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC# <br /> Dublin CA 94568 Closure Installation Repair Retrofit <br /> ACTIVE FACILITY <br /> 2004 2005 2006 2007 2008 2009 <br /> $500 FEE INCLUDES FACILITY FEE+1 TANK(2004-2007) <br /> $550 FEE INCLUDES FACILITY FEE+1 TANK(2008-2009) <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=$24.00/FACILITY $ <br /> PERMANENT CLOSURE <br /> Removal or Permitted Closure in Place <br /> TANK ID# s CLOSURE FEE=$315/TANK #TANKS X$315= $ <br /> TEMPORARY CLOSURE <br /> Plan Review and Inspections) <br /> $ <br /> TANK ID#(s): I TEMPORARY CLOSURE FEE_$315/FACILITY <br /> INSTALLATION PLAN CHECK <br /> Plan Check and Construction Ins ections <br /> TANK ID#(s): PLAN CHECK FEE_$840!FACILITY $ <br /> REPAIR PLAN CHECK <br /> TANK ID#(s): <br /> TANK RETROFIT REPAIR FEE =$315/FACILITY (use for monitoring equipment, cold starts,EVR upgrades, $ 390 <br /> spill buckets,sumps,mist. <br /> PIPING REPAIR FEE _$315/FACILITY (use for piping, under-dispenser containment,ect.) $ <br /> MISCELLANEOUS <br /> TRANSFER FEE _ $20 $ <br /> CONSULTATION FEE = $105/HOUR $ <br /> UNAUTHORIZED RELEASE EVALUATION FEE _ $ 105/HOUR $ <br /> SAMPLING INSPECTION FEE = S 105/HOUR $ <br /> ALL FEES ARE BASED ON THE$105 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. <br /> OFFICE USE ONLY <br /> SERVICE REQUEST# FACILITY ID JAMOUNT RECEIVED CHECK# RECEIVED BY DATE RECEIVED <br /> SR <br /> Received TIrne('Apr, 20, E°2015 4 . 14AM N:, ��y <br />