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.or !g ehd FACILITY NAME FACILITY CONTACT NAME Dr2g35fvt- -E . c - l cAiNIS 1 wer;n 9 FACILITY ADDRESS SITE PHONE # WITH AREA CODE / y03 Cd(t ou —pty Ct_ud ALL)a ( ?//.) 87c::,- 399t) CITY STATE ZIP CODE # OF TANKS AT SITE E7Z> UZ-M O I CA I I l APPLICANT BILLING NAME ACTIVE APPLICANT CONTACT NAME Dr2g35fvt- -E . c - A //e,. —7 -� a,M 4s APPLICANT MAILING ADDRESS APPLICANT PHONE # WITH AREA CODE 25-19 ( ?//.) 87c::,- 399t) CITY STATE I ZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC # W4W— S4-CrL A,% E>,)-ftn, Cc, I 4 5 691 Closure Installation(Hai Retrofit $ 2 3 B -7 -/Z - %7Z - ACTIVE FACILITY TANK ID # (s): CLOSURE FEE = $315 / TANK 2004 2005 2006 2007 2008 2009 $500 FEE INCLUDES FACILITY FEE + 1 TANK (2004-2007) $315 PIPING REPAIR FEE _ $315 /FACILITY use for piping, under -dispenser containment, ect. 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) : I PLAN CHECK FEE = $840 / FACILITY REPAIR PLAN CHECK TANK ID # (s) : TRANSFER FEE _ $ 20 TANK RETROFIT REPAIR FEE = $315 / FACILITY (use for monitoring equipment, cold starts, EVR upgrades, spill buckets, sumps, misc. $315 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 # I RECEIVED BY DATE RECEIVED SR EH 23 032 (REVISED 03/20/09)