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-SiRov.oralehd <br /> FACILITY NAME FACILITY CONTACT NAME <br /> Chevron Helen McCarty <br /> FACILITY ADDRESS SITE PHONE#WITIJ AREA CODE <br /> 1960 W 11 th St,Tracy CA 95376 209-8 6-3181 <br /> CITY STATE ZIP CODE #OF TANKS AT SITE <br /> Tracy CA 95376 <br /> 3 <br /> APPLICANT BILLING NAME APPLICANT.CONTACT NAME <br /> Service Station Systems, Inc. Marty Weithman <br /> APPLICANT MAILING ADDRESS APPLICANT PHONE#WITH AREA CODE <br /> 680 Quinn Ave. <br /> 408 213-6038 <br /> CITY ZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC# <br /> San�JosE����951112 <br /> 5258560 <br /> ACTIVE FACILITY <br /> $500 FEE INCLUDES FACILITY FEE+1 TANK(2003-2008) 2004 2005 2006 2007 2008 2009 <br /> $550 FEE INCLUDES FACILITY FEE+1 TANK(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 COPA PROGRAM=$24.OD/FACILITY $ <br /> PERMANENTCLOSURE <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 lions <br /> TANK ID#(s): TEMPORARY CLOSURE FEE_$3151 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, $ <br /> s ill buckets surnDs.misc.) 375 <br /> PIPING REPAIR FEE =$315/FACILITY use fiD 31iD,in ,under-cls ser containmen6 ed.) $ <br /> MISCELLANEOUS <br /> TRANSFER FEE = 20 $ <br /> CONSULTATION FEE = $105/HOUR $ <br /> UNAUTHORIZED RELEASE EVALUATION FEE _ $105!HOUR $ <br /> SAMPLING INSPECTION FEE _ $1051 HOUR $ <br /> ALL FEES ARE BASED ON THE t105 HOURLY RATE.TIME THAT EXCEEDS FEES PAID WILL BE BILLED To APPLICANT. <br /> OFFICE USE ONLY <br /> f <br /> RVICEREQUESTtt FACILITY IDMOUNTRECEIVED CHECK# RECEIVED By DATER <br /> EH 23 032(REVISED 02/29/09) <br />