Laserfiche WebLink
SAN JOAQUIN 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.siog v.or <br />FACILITY NAME <br />FACILITY CONTACT NAME <br />+BSI-LLLING <br />0.�-''r' Csl+J a v®Y� v "C.Q.S <br />�..� � C.4�6�t►.l � CI^G- v^� O �- <br />FACILITY ADDRESS <br />SITE PHONE # WITH AREA CODE <br />3%A S N . •S ® P -k v e r.. <br />-it to -Z-s 5"4ib - l o g O <br />CITY STATE <br />ZIP CODE # OF TANKS AT SITE <br />5G—i-tea-'' CA <br />Irl a 2..® Z- 1 <br />APPLICANT NAME <br />APPLICANT CONTACT NAME <br />+BSI-LLLING <br />0.�-''r' Csl+J a v®Y� v "C.Q.S <br />�..� � C.4�6�t►.l � CI^G- v^� O �- <br />APPLICANT MAILING ADDRESS <br />APPLICANT PHONE # WITH AREA CODE <br />P111b® k -C*- - Cp.•1�+t:L tLav°t� <br />Glto �S�"Q7 ' 1-0a1 O <br />CITY <br />STATE <br />ZIP CODE <br />CIRCLE WORK TO BE DONE <br />CONTRACTOR ICC # <br />�o Cord ®vA <br />C.e` <br />GiS'7 `12_ <br />Closure Installation Repair Retrofit <br />$550 FEE INCLUDES FACILITY FEE + 1 TANK (2008-20'10) <br />ACTIVE FACILITY <br />TANK ID # (s): <br />CLOSURE FEE = $366 / TANK <br />2005 <br />2006 <br />2007 <br />2008 <br />2009 <br />2010 <br />$500 FEE INCLUDES FACILITY FEE + 1 TANK (2005-2007) <br />$ <br />PIPING REPAIR FEE = $366 / FACILITY use for piping, under -dispenser containment, ect. <br />$ <br />SAMPLING INSPECTION FEE = $ 122/ HOUR <br />$550 FEE INCLUDES FACILITY FEE + 1 TANK (2008-20'10) <br />$ <br />$125 PER TANK AFTER FIRST TANK <br />$ <br />TANK PENALTY ASSESSED <br />$ <br />TANK SURCHARGE = $15 / TANK <br />$ <br />STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM =$49.00/ FACILITY <br />PERMANENT CLOSURE <br />Removal or Permitted Closure in Place <br />TANK ID # (s): <br />CLOSURE FEE = $366 / TANK <br /># TANKS X $366 = <br />TEMPORARY CLOSURE <br />Plan Review and Ins ections <br />TANK ID # (s) : <br />TEMPORARY CLOSURE FEE = $366 / FACILITY <br />and <br />TANK ID # (s) : <br />PLAN CHECK FEE = $976 / FACILITY <br />REPAIR PLAN CHECK <br />TANK ID # (s) : <br />$ <br />TRANSFER FEE _ $ 25 <br />$ <br />TANK RETROFIT REPAIR FEE = $366 / FACILITY (use for monitoring equipment, cold starts, EVR upgrades, <br />$ <br />spill buckets, sumps, misc. <br />$ <br />PIPING REPAIR FEE = $366 / FACILITY use for piping, under -dispenser containment, ect. <br />MISCELLANEOUS <br />$ <br />TRANSFER FEE _ $ 25 <br />$ <br />CONSULTATION FEE = $ 122/ HOUR <br />$ <br />UNAUTHORIZED RELEASE EVALUATION FEE = $ 122 / HOUR <br />$ <br />SAMPLING INSPECTION FEE = $ 122/ HOUR <br />ALL FEES ARE BASED ON THE $122 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. <br />OFFICE USE ONLY <br />