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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.sf ov orehd <br />FACILITY NAME <br />FACILITY CONTACT NAME <br />AT&T (00010) <br />Bruce Amundson <br />FACILITY ADDRESS <br />SITE PHONE # WITH AREA CODE <br />1812 Coley Ave, Escalon CA 95320 <br />(559--2F2-2313 <br />CITY <br />I STATE <br />ZIP CODE # OF TANKS AT SITE <br />Escalon <br />CA <br />95320 <br />1 <br />APPLICANT BILLING NAME <br />APPLICANT CONTACT NAME <br />Service Station Systems, Inc. <br />MartyWeithman <br />APPLICANT MAURG ADDRESS <br />APPLICANT PHONE #—TH AREA CODE <br />680 Quinn Ave. <br />408 .213-6038 <br />CITYSTATE <br />ZIP CODE <br />CIRCLE WORK TO BE DONE <br />CONTRACTOR ICC <br />San Jose <br />CA 95112 <br />TANK PENALTY ASSESSED <br />5258560 <br />0 <br />ACTIVE FACILITY <br />$ <br />$500 FEE INCLUDES FACILITY FEE + 1 TANK (2003.2008) <br />$550 FEE INCLUDES FACILITY FEE + 1 TANK (2009) <br />$125 PER TANK AFTER FIRST TANK <br />2004 <br />2005 <br />2006 <br />2007 <br />2008 2009 <br />TANK PENALTY ASSESSED <br />$ <br />TANK SURCHARGE = $15 /TANK <br />STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM =$24.Ot)/ FAClCITY <br />$ <br />TANK RETROFIT REPAIR FEE = $315 / FACILITY (use for monitoring equipment, cold starts, EVR upgrades, 375 I <br />mill" k-6-4- ....�-� -.-_ , <br />MISCELLANEOUS <br />TRANSFER FEE _ $ 20 <br />$ <br />CONSULTATION FEE = $ 105/ HOUR <br />$ <br />UNAUTHORIZED RELEASE EVALUATION FEE = $ 105 / HOUR <br />$ <br />SAMPLING INSPECTION FEE= $ 105/ HOUR <br />ALL FEES ARE RASFn nm TNF i unl lD v oAT= 7tUM V-1 <br />$ <br />