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FOR OFFTC£ USE ONLY _pAT£ ltEC`IVED <br />SL1£rDS $ 4 C04PUTER 3 LOC COME ! 01ST CCD£ f A"OUNT R INE 1 CIIEtX /CASzR —RE. -.INFO SY S <br />EH Z3 p32 (REVtSO 1-12-48) <br />8-25-1998 3:59PM FROM <br />SAM 1oAotlZR PUBLIC y£ALT9 SSEVI= - Sm AL DIVSION <br />• <br />S WAGE TAXX POCRM_ <br />FEE <br />-: <br />rAGA :1"t CC 'M� 75 <br />1 • 4Wz" <br />SBl FACILITY SITE NAME.�1 (� <br />L <br />`� °- <br />I< <br />Tu <br />'t:EFACILITT2S�hGl �/'T1 41-1IP <br />th anE <br />SITE/� �:7I� 1,14® <br />CCUE <br />ZQ52� at SIANKSA" <br />��ST£� <br />cA 4 <br />1111 <br />p <br />NAME <br />APPLtG�1T t3Oi4AGT <br />T <br />p Ap®LICANT/SILLING <br />� <br />EAG • <br />L L / <br />I <br />APPLICANT P!)ONi£ WITH AREA CME <br />C FAILING ADO ESS' <br />A -1 <br />L,o <br />I{ S'l ! <br />j STAT'c <br />/�+ <br />ZIP <br />E <br />11 aYP£ of aPpt.LCA4I0N <br />CCI 'r, iczstaliaLia�. etc_) t UA <br />TE CITY �! 16n4A <br />V`/4 <br />CA <br />1 ` <br />"1 <br />I <br />j <br />TOTAL <br />14$b 1487 1488 5489 t 1440 <br />ANNUAL FACILITY Fs-= (prior to dancsary 1, 1941) = S1W-00 <br />X7Gpt <br />S )OC)OOCXX)C <br />A <br />CCIf <br />j �ooa (, j xxxx f x)oct xxx�c 3 xananoopc <br />TI fACiLITY P639ALTY fi S ASSN Appticabie) <br />I1,1941) f <br />V TANK Fc_ = SS0.00/TA" (Prior to January <br />S170/TANK CAfcer .tw—ry 1, 1991) <br />1997 1948 <br />z <br />=jt <br />198$ 1489 1990 1 1991 1992 <br />1993 , 1991 11945 1946 f <br />e Tanks <br />F cmutLipL-f by fe" TOr <br />x t 7()Q►'X ` MOO: <br />A each year appticabtc) <br />c' I Exxx$ <br />xXXX 7WCX <br />, 1 f <br />i ` TAN1K PENALTY FEES ASSaSS£D kX <br />S <br />Lt <br />E! STATE SURCHARf0R NEW FAG:L:TI£S C:I4 +28.50 <br />Tw <br />19$8 darougss t943 M6)t993 <br />* 1497 =(356),998 <br />Y Tank x38.00 <br />� S <br />SURCHARGEFOR 1998 <br />1 <br />a <br />C} pc-.ZmME4T CLOSURE CRemwaL or AutT'*rfzed Clc$ure-in-?la�P <br />TALC I.il_ AS) <br />L�TANICtS) <br />' S78_0O/hour (3 hours ainjuLmITASK) <br />0� CLOSURE rY= <br />- <br />x 3234.00 3 <br />Sii <br />UI ;E )RARY CLOSURE (plan Review tnspec=ions) <br />TANK I.3. 2(S) <br />S <br />R <br />E,^�OpORARY CLOSURE fcc = 578_OO/haa�c' t3 hours minimmam/FAC'_LIT7) � <br />5734.'JO aoonimcaa <br />Inview b C=trl= -"on InspC-=s�)l TAW <br />pi INSTALLATION PLAN C1i£{X CP <br />L <br />A= S78_QOlhotu C8 kasa s miniaaWFACILITY) <br />a PANME= fen <br />S <br />iaini = S6Z4_OO w <br />z{ 2�AIR r CyorfOstan Reviex b Cons^ _ion tnspec-d a-) <br />TANK I _D _ A S I <br />E,x <br />pf TANK LINING REPAIR FEE = 578.00!)*aa' (3 hours sainiawmdTAarn <br />TANYCS) x SZ34_t$1 i <br />S �� . oc <br />A <br />I <br />TANIK RETROFIT REPAIR r= = 578_CtO/lsocu C3 hoar min_/FAC:LITT) <br />m 5234-00 Minimm <br />3 <br />R <br />?IPLNG REPAIR rE° = S78_00/hoar (3 hours minimums/FACILITY) <br />= SZ34.00 minimum <br />y S <br />1 TRAIiStr rca _ IZ`M �LASc £YALVATIQY S78_SMlhr <br />i <br />S•c <br />C: C=SULTATION FEE= VB-C10/hr SAMPLING INSPECTICN Fc <br />578_(�lhr <br />Z� <br />TOTAL MES <br />FOR OFFTC£ USE ONLY _pAT£ ltEC`IVED <br />SL1£rDS $ 4 C04PUTER 3 LOC COME ! 01ST CCD£ f A"OUNT R INE 1 CIIEtX /CASzR —RE. -.INFO SY S <br />EH Z3 p32 (REVtSO 1-12-48) <br />