Laserfiche WebLink
SAN JOAQUIN COUNTY 40 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,Stockton,CA 95202-3029 <br /> Telephone.(209)468-3420 Fax.(209)468-3433 Web:www.s L0v or&/ehd <br /> FACILITY NAME FACILITY CONTACT NAME <br /> Chevron USA Andrea <br /> FACtuTY ADDRESS SITE OKE] WITH AREA CODE <br /> 6633 Pacific Ave Stockton CA 95207 (209-417-4294 <br /> CITY STATE ?JP CODE #OF TANKS AT SITE <br /> Stockton CA 95204 <br /> 3 <br /> APPLICANT BILLING NAME APPLICANT CONTACT NAME <br /> Service Station Systems, Inc. <br /> Marity Weithman <br /> APPLICANT MAILING ADDRESS APPLICANT PHONE#I WITH AREA CODE <br /> 680 Quinn Ave. <br /> 408 213-6038 <br /> CITY STATE IIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC_#_1 <br /> San Jose CA 95112 <br /> 0 8001468-UT <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 CUPA PROGRAM=$24.00/FACILITY $ <br /> PERMANENT CLOSURE <br /> Removal or Permitted Closure in Place <br /> TANK ID#(s): CLOSURE FEE=$315/TANK #TANKS X$315= $ <br /> TEMPORARY CLOSURE <br /> Pin Review and Ins coons <br /> TEM <br /> TANK ID#(s): PORARY CLOSURE FEE_$315/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 I FACILITY (use for monitoring equipment,cold starts,EVR upgrades, $ 366 <br /> s ill buckets <br /> sumps,mise. <br /> PIPING REPAIR FEE =$315/FACILITY use for piping,under-dispenser containment,ect. $ <br /> MISCELLANEOUS <br /> TRANSFER FEE = 20 $ <br /> CONSULTATION FEE = $105/HOUR $ <br /> UNAUTHORIZED RELEASE EVALUATION FEE _ $105/HOUR $ <br /> SAMPLING INSPECTION FEE _ $105/HOUR $ <br /> ALL FEES ARE BASED ON THE$105 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLCANT. <br /> OFFICE USE ONLY <br /> SERVICE REQUEST# FACILITY ID AMOUN I CHECK—# RECEIVED BYDATE RECEIVED <br /> SR <br /> EH 23 032(REVISED ROOM) <br />