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.9255517888 Line 1 11 :16 a.m. 05-18-2009 7/12 <br /> SAN JOAQUnN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,Stockton,CA 95202-3029 <br /> Telephone.(209)468-3420 Fax:(209)468-3433 Web:www.si o� v.org(ehd <br /> FACILITY NAME FACILITY CONTACT NAME <br /> ARCO 2093 <br /> FACILITY ADDRESS SITE PHONE#WITH AREA CODE <br /> 3425 TRACY BLV® 925 551-7555 <br /> CITY STATE ZIP CODE #OF TANKS AT SITE <br /> TRACY CA 95376 <br /> APPLICANT BILLING NAME APPLICANT CONTACT NAME <br /> Gettler Ryan Inc. LIDDY MCKEN23E <br /> APPLICANT MAILING ADDRESS APPLICANT PHONE#WITH AREA CODE <br /> 6747 Sierra Court,Suite J 925 551-7555 <br /> CITY I STATE I ZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC# <br /> Dublin I CA 94568 Closure Installation Repair Retrofit 5250455-UI <br /> ACTIVE FACILITY <br /> $500 FEE INCLUDES FACILITY FEE+1 TANK(20042007) 2004 2005 2006 2007 2008 1 2009 <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 /> Pian Review and In ctians <br /> TANK ID#(s): TEMPORARY CLOSURE FEE_$315/FACILITY <br /> INSTALLATION PLAN CHECK <br /> Plan Check and Construction Inspections) <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, 315 <br /> split buckets sum misc. <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 _ $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 0 FACILITY ID AMOUNT RECEIVED CHECK N RECEIVED BY DATE RECEIVED <br /> SIR <br /> EH 23 032(REVISED 03/20109) <br />