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SAN JUAUUiN LUUAL MMMU 1 n Lia 1 ma-+ <br /> 'RGROtIND STORAGE TANK PROGRAM - FEE WORKSH, <br /> F FACILITY/SITE NAME FACILITY COACT NAME <br /> A Port of Stockton Aldo Freggiaro <br /> I <br /> I STREET ADDRESS 2201 W. Washington SITE PHONE # (with Area Code) <br /> (209) 946-0246T <br /> Y CITY Stockton . STATE IIP CODE # of TANKrS <br /> CA lat Site <br /> A APPLICANU BILLING NAME APPLICANT CONTACT NAME <br /> P Port of Stockton Aldo Freggiaro <br /> P <br /> L <br /> I MAILING ADDRESS P. 0. Box 2089 APPLICANT PHONE I (with Area Code) <br /> C 209 946-0246 <br /> ACITY e of e-excava on <br /> N 5TATE IIP CODE TYPE of APPLICATION <br /> bit- / <br /> Stockton, CA (Closure, Installation, etc,) work plan <br /> FACILITY FEE _ $100.00 each SITE ADDRESS per YEAR TOTAL <br /> A <br /> C 1986 1987 1988 1989 <br /> T $ <br /> i <br /> V <br /> E TANK FEE = $50,00 each TANK <br /> F I Tanks x $50.00 1986 1981 1988 1987 <br /> A (multipTy-1-by fee for $ <br /> C each year applicable) <br /> L STATE SURCHARGE = $56.00 each TANK (see CA HEALTH t SAFETY CODE Sec 2581 for applicability) <br /> I <br /> T 11 Tanks r $56.00 1986 1987 1988 1989 <br /> Y (enter eiount and year) $ <br /> C PERMANENT CLOSURE (Removal or Closure-in-place) <br /> L <br /> 0 CLOSURE FEE = $90.00 each TANK # Tanks z $90.00 $ <br /> U <br /> P. TEMPORARY CLOSURE (Only allowed one time for up to two years) <br /> E <br /> TEMPORARY CLOSURE FEE = $80.00 each TANK I Tanks x $80.00 $ <br /> P PLAN CHECK (installation or Repair) <br /> L <br /> A <br /> N PLAN CHECK FEE _ $30.00 each SUBMISSION/RESUBMISSION $ <br /> REPAIR <br /> R <br /> E TANK REPAIR FEE _ $110.00 each TANK I Tanks x $110.00 $ <br /> A <br /> 1 PIPING REPAIRICLOSUREIREMOVAL (Fees are per hour, minimum one hour to be paid on plan submittal) <br /> R <br /> UNAUTHORIZED RELEASE EVALUATION CONSTRUCTION Site/SoilSAMPLING <br /> (when applicable) INSPECTION re- xcavatin INSPECTION <br /> FEE _ $30.00/hr FEE = $35.00/hr 35.00 FEE _ $35.40/hr 35.00 $ 70.00 <br /> TOTAL DUE $ <br /> OFFICE USE ONLY <br /> SWEEPS I COMP # LOC CODE DIST CODE AMOUNT DUE AMOUNT $CVD CHECK #/CASH RCVD BY DATE RECEIVED PERMIT I <br /> tr � <br />