Laserfiche WebLink
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.sipov.org/ehd <br /> FACILITY NAME FACILITY CONTACT NAME <br /> H & M Market ( Kwik Serv) Monica Farhat <br /> FACILITY ADDRESS SITE PHONE # WITH AREA CODE <br /> 2501 Jackson Ave , Escalon CA 95320 209-8 8-3971 <br /> CITY STATE ZIP CODE # OF TANKS AT SITE <br /> Tracy CA 95320 3 <br /> APPLICANT BILLING NAME APPLICANT. CONTACT NAME <br /> Able Maintenance Inc Mart Weithman <br /> APPLICANT MAILING ADDRESS APPLICANT PHONE # WITH AREA CODE <br /> 680 Quinn Ave . <br /> 408- 213-6038 <br /> CITY STATE ZIP COOE CIRCLE WORK TO BE DONE CONTRACTOR ICC # <br /> San Jose CA 95112 C� <br /> ME will �� 5250610 <br /> ACTIVE FACILITY <br /> 2004 2005 2006 2007 2008 2009 <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 /> 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 /> Plan Review and Ins coons <br /> TANK ID # (s) : TEMPORARY 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 / FACILITY (use for monitoring equipment, cold starts. EVR upgrades, $iqg � <br /> s III buckets, sum s, misc. <br /> PIPING REPAIR FEE _ $315 ! FACILITY use for piping, under4spenser containment, act. $ <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 APPLICANT. <br /> OFFICE USE ONLY <br /> EEQUEST # FACILITY ID AMOUNT RECEIVED CHECK # RECEIVED RECEIVED _ <br /> L� I 1� <br /> EH 23 032 (REVISED 02/23/09) <br />