COMPLIANCE INFO_2009-2010 - Laserfiche WebLink

Home Browse Search

0 SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd FACILITY NAME FACILITY CONTACT NAME Cjk-Ut � 70 5 q(-[� M(''0- FACILITY ADDRESS SITE PHONE # WITH AREA CODE l46� —"3 CITY STATE ZIP CODE # OF TANKS AT SITE ISTATE CA 96 t x(--y7/v0;- APPLICANT BILLING NAME TANK ID # (s): APPLICANT CONTACT NAME Z )l r tv7 1 �pc-. 2005 A Ili X1,4" as APPLICANT MAILING ADDRESS 2008 APPLICANT PHONE # WITH AREA CODE , CITY ISTATE I ZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC # SAMPLING INSPECTION FEE _ $ 105/ HOUR CC .11 Closure Installation Repair Retrofit ACTIVE FACILITY TANK ID # (s): CLOSURE FEE = $315 / TANK 2004 2005 2006 2007 2008 2009 $500 FEE INCLUDES FACILITY FEE + 1 TANK (2004-2007) $ UNAUTHORIZED RELEASE EVALUATION FEE = $ 105 / HOUR $ SAMPLING INSPECTION FEE _ $ 105/ HOUR $550 FEE INCLUDES FACILITY FEE + 1 TANK (2008-2009) $125 PER TANK AFTER FIRST TANK $ TANK PENALTY ASSESSED TANK SURCHARGE = $15 / TANK STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM =$24.00/ FACILITY PERMANENT CLOSURE Removal or Permitted Closure in Place TANK ID # (s): CLOSURE FEE = $315 / TANK # TANKS X $315 = TEMPORARY CLOSURE Plan Review and Inspections) TANK ID # (s) : TEMPORARY CLOSURE FEE = $315 / FACILITY INSTALLATION PLAN CHECK Plan Check and Construction Inspections) $ TANK ID # (s) : PLAN CHECK FEE = $840 / FACILITY REPAIR PLAN CHECK TANK ID # (s) : TANK RETROFIT REPAIR FEE = $315 / FACILITY (use for monitoring equipment, cold starts, EVR upgrades, spill buckets, sumps, misc. PIPING REPAIR FEE = $315 / FACILITY use for piping, under -dispenser containment, ect. MISCELLANEOUS $ TRANSFER FEE _ $ 20 $ CONSULTATION FEE _ $ 105/ HOUR $ UNAUTHORIZED RELEASE EVALUATION FEE = $ 105 / HOUR $ SAMPLING INSPECTION FEE _ $ 105/ HOUR ALL FEES ARE BASED ON THE $105 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. OFFICE USE ONLY SERVICE REQUEST # FACILITY ID AMOUNT RECEIVED CHECK # RECEIVED BY DATE RECEIVED SR EH 23 032 (REVISED 03/20/09)