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P <br /> FEE WORKSHEET P R I M A - CAST& MFG. INC. <br /> w•. ^ <br /> DBA inueiirrAluminum <br /> Y '� Produtl on <br /> i d' a Mach na <br /> DBA. Schmidt's Grinding & Mfg, <br /> ADDRESS 1220 E. Pine Street, Lodi, Calif, 95240 (209 3G 1� <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a, Existing Facility and 1st Tank @ $150. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit) <br /> ($56 x Tot.-1 # Tanks) <br /> 3. *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) <br /> 4. *Permanent Closure (per tank) Underground Storage Tank in which <br /> storage has ceased and where the owner/operator has no intent <br /> of re-using tank within next 2 years. <br /> (# Permanent Closures x $g0) 9400 <br /> Total Number of Tanks __ <br /> Total Fee Due O,OD <br /> Make all fees payable to San Joaquin Local Health District Enclose this worksheet <br /> with your check and the completed application. <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 <br /> 2. State Surcharge, 4 Tanks x $56 D P 2 V do <br /> Total Number of Tanks 4 Total Fee Due $5 2 5 1986 <br /> ENVIROMENTAL HEALTH <br /> PERMIT/SERVICES <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 12/85 <br />