Laserfiche WebLink
SA*AQUIN COUNTYENVIRONMENTAL <br />:. I • s A ' <br />APPLICANT BILLING NAME <br />• <br />:w <br />APPLICANT CONTACT NAME <br />Q <br />q e- <br />APPLICANT MAILING ADDRESS <br />2003 2004 <br />PLK:ANT PHONE # WITH AREA CODE <br />W41 ali*ik # OF TANKS AT SITE <br />($170)x(ftnks) <br />CITY <br />APPLICANT BILLING NAME <br />TANK ID # s : <br />APPLICANT CONTACT NAME <br />Q <br />q e- <br />APPLICANT MAILING ADDRESS <br />2003 2004 <br />PLK:ANT PHONE # WITH AREA CODE <br />$500 FEE INCLUDES FACILITY FEE + 1 TANK <br />($170)x(ftnks) <br />CITY <br />1 STATE <br />ZIP CODE CIRCLE WORK TO BE DONE: <br />Closure Installation epai Retrofd <br />Mo ec <br />ACTIVE FACILITY <br />TANK ID # s : <br />CLOSURE FEE = $279 /TANK <br />1999 <br />2000 <br />2001 <br />2002 <br />2003 2004 <br />CONSULTATION FEE = $ 93/ HOUR <br />$500 FEE INCLUDES FACILITY FEE + 1 TANK <br />($170)x(ftnks) <br />UNAUTHORIZED RELEASE EVALUATION FEE _ $ 93 ! HOUR <br />$125 PER TANK AFTER FIRST TANK <br />$ <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 : <br />CLOSURE FEE = $279 /TANK <br /># TANKS X $279 <br />TEMPORARY CLOSURE <br />Ian Review and Inspections) <br />TANK ID # (s) : <br />TEMA ORARY CLOSURE FEE = $279 / FACILITY <br />REPAIR PLAN CHECK <br />TANK ID# (s): <br />$ <br />TANK RETROFIT REPAIR FEE = $279 / FACILITY use for monitoring equipment, spill buckets, tank sumps, misc.) <br />PIPING REPAIR FEE = $279 / FACILITY (use for piping, under -dispenser containment, act.) <br />MISCELLANEOUS <br />$ <br />TRANSFER FEE _ $ 20 <br />CONSULTATION FEE = $ 93/ HOUR <br />UNAUTHORIZED RELEASE EVALUATION FEE _ $ 93 ! HOUR <br />SAMPLING INSPECTION FEE = $ 93/ HOUR <br />ALL FEES ARE BAS® ON THE $s3 HOURLY RATE Tmae 7 HA a Exianc is rcmm rsuty VV.,. o= ®n.v--• • i .. <br />