COMPLIANCE INFO_1998-2009 - Laserfiche WebLink

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SAN JOAQUIN COUNTY 10 ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.orgJehd FACILITY NAME FACILITY CONTACT NAME J 2004 FACILITY ADDRESS SITE PHONE # WITH AREA CODE APPLICANT MAILING ADDRESS FAD CITY STATE ZIP CODE I # OF TANKS AT SITE f CA -5 ZIP CODE APPLICANT ILLING NAME TANK ID # (s): APPLICANT CONTACT NAME 2004 C,�t�? C1 APPLICANT MAILING ADDRESS 2008 APPLICANT PHONE # WITH AREA CODE PIPING REPAIR FEE = $345 / FACILITY (use for piping, under -dispenser containment, ect.) $500 FEE INCLUDES FACILITY FEE + 1 TANK (2004-2007) CITY STATE ZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC # $550 FEE INCLUDES FACILITY FEE + 1 TANK (2008-2009) $125 PER TANK AFTER FIRST TANK Closure Installation C!paip Retrofit ACTIVE FACILITY TANK ID # (s): CLOSURE FEE = $345 / TANK 2004 2005 2006 2007 2008 2009 PIPING REPAIR FEE = $345 / FACILITY (use for piping, under -dispenser containment, ect.) $500 FEE INCLUDES FACILITY FEE + 1 TANK (2004-2007) UNAUTHORIZED RELEASE EVALUATION FEE = $ 115 / HOUR SAMPLING INSPECTION FEE _ $ 115/ 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 =$49.00/ FACILITY PERMANENT CLOSURE Removal or Permitted Closure in Place TANK ID # (s): CLOSURE FEE = $345 / TANK # TANKS X $345 = TEMPORARY CLOSURE Plan Review and Inspections) TANK ID # (s) : TEMPORARY CLOSURE FEE = $345 / FACILITY INSTALLATION PLAN CHECK Plan Check and Construction Inspections) TANK ID # (s) : I PLAN CHECK FEE = $920 / FACILITY REPAIR PLAN CHECK TANK ID # (s) : $ $ TANK RETROFIT REPAIR FEE = $345 / FACILITY (use for monitoring equipment, cold starts, EVR upgrades, spill buckets, sumps, misc. CONSULTATION FEE _ $ 115/ HOUR PIPING REPAIR FEE = $345 / FACILITY (use for piping, under -dispenser containment, ect.) $ 34-C MISCELLANEOUS $ TRANSFER FEE _ $ 20 CONSULTATION FEE _ $ 115/ HOUR UNAUTHORIZED RELEASE EVALUATION FEE = $ 115 / HOUR SAMPLING INSPECTION FEE _ $ 115/ HOUR ALL FEES ARE BASED ON THE $115 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 $R EH 23 032 (R , ,!7/01109)