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)BA, <br />'AILING <br />Operating Permit Application/Annual Inspection Fee <br />a. First Tank at Facility @ $150. <br />b. Additional Tanks(/ Additional Tanks x $50) <br />State Surcharge (per; tank) (Due with Permit Application, <br />on renewal or amendment of operation permit andtemporary closure) <br />($56 x Total / Tanks) <br />l+ "Temporary Closure (per tank) Underground Storage Tank in which <br />storage has ceased but where the owner/operator proposes to <br />re -use tank within 2 years. <br />(/_ Temporary closures x $80) (See above i3 to calculate surcharge) <br />I• <br />*Permanent Closure (per tank) Underground Storage Tank in which <br />storage has ceased and where the gwner/operator hPANAntt nt <br />ENT <br />of re -using tank. 'RECEIVED <br />(1—L Permanent Closures x $90) NOV 2 8 1988 <br />i. Plan Check Fee $30. <br />Total Number of Tanks <br />.ENVIRONMENTAL HEALTH <br />PERMITJSERVICES <br />Total Fee Oue <br />q0 <br />�-a—d <br />Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br />with your check. <br />PAY <br />AL WILLIAMSON <br />GENERAL CONTRACTING <br />PH. 931-8810 <br />4900 N. HIGHWAY 99, NO. 208 <br />STOCKTON, CA 95212 <br />y p� Valley Commercial Bank <br />P.O. Boxox 9'100 <br />1091 E" Wwd. Road <br />Sbekto4 CaW.mi.ia 96408 <br />11-24' 19A� <br />- - -` DOLLARS$ <br />r <br />TO <br />THE � (�J n .4A <br />ORDER iiIGKK..J�% VV �T V ��((��LLCs� <br />OF <br />:.. a..... _..� . -. <br /> <br />