Laserfiche WebLink
SAND A0UIN <br /> Environmental Health apartment <br /> (-- COUNTY--- <br /> Ll ( F l (7LCS jf061! 5 flE.' IZ . <br /> FACILITY NAME FACILITY CONTACT NAME <br /> Waterloo Liquors Mr. Heng <br /> FACILITY ADDRESS SITE PHONE # WITH AREA CODE <br /> 2512 E Waterloo Rd ( 209 ) 607-5022 <br /> CITY STATE ZIP CODE # OF TANKS AT SITE <br /> Stockton CA 95205 <br /> APPLICANT BILLING NAME Megan Mitchell APPLICANT CONTACT NAME Megan <br /> APPLICANT MAILING ADDRESS 2535 Wigwam Dr A5byCANT &y?%55PITH AREA CODE <br /> CITY STE ZIP CODE CIRCLE WORK TO BE DONE CONTRACTOR ICC # <br /> Stockton 95205 <br /> Closure Installation Repair Retrofit <br /> ACTIVE FACILITY <br /> UST FEES = $550 2014 2015 UST FEES 2016 UST FEES 2017 VPH UST FEES = 2018 $ <br /> (Facility+ 1st = $583 = $641 $961 Facility + <br /> Tank) + $130/Tank Facility + Facility + $228/Tank <br /> after 1st $139/Tank $152/Tank <br /> Double Wall & 1702 $ <br /> Compliant UST <br /> FEES = $680 <br /> Facility + $228/Tank <br /> Tank Penalty $ <br /> Assessed for <br /> Unreported Tanks <br /> (Based on Annual <br /> Permit Fees <br /> TANK SURCHARGE _ $201 TANK <br /> STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM =$49 .00/ FACILITY $ <br /> PERMANENT CLOSURE <br /> Removal or Permitted Closure in Place <br /> TANK ID # (s) : CLOSURE FEE = $456 / TANK # TANKS X $456 = $ <br /> TEMPORARY CLOSURE <br /> (Plan Review and Inspections <br /> TANK ID # (s) : TEMPORARY CLOSURE FEE _ $456 / FACILITY $ <br /> INSTALLATION PLAN CHECK <br /> Plan Check and Construction Inspections) <br /> TANK ID # (s) : PLAN CHECK FEE _ $3,040 / FACILITY $ <br /> REPAIR PLAN CHECK <br /> TANK ID # (s) : <br /> $ <br /> TANK RETROFIT REPAIR FEE _ $456 / FACILITY (use for monitoring equipment, cold starts, EVR upgrades, 456 .00 <br /> Spill buckets, sumps, misc.) <br /> PIPING REPAIR FEE = $456 / FACILITY (use for piping, underAispenser containment, etc. <br /> MISCELLANEOUS <br /> TRANSFER FEE = $ 25 $ <br /> CONSULTATION FEE _ $ 1521 HOUR $ <br /> UNAUTHORIZED RELEASE EVALUATION FEE _ $ 152 / HOUR $ <br /> SAMPLING INSPECTION FEE _ $ 152/ HOUR $ <br /> FEES ARE BASED ON THE $152 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. <br /> TOTAL AMOUNT DUE $ <br /> OFFICE USE ONLY <br /> SERVICE REQUEST # FACILITY ID AMOUNT RECEIVED CHECK # RECEIVED BY DATE RECEIVED <br /> 1868 E . Hazelton Avenue Stockton , California 95205 T 209 468 -3420 F 209 464 -0138 1 www.sjcehd ,com <br />