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7 <br /> • 0 <br /> r <br /> SEE WORkSHLET PER EACH FACILITY <br /> • FACILITY <br /> DBA IAWMORE REPAIR ADDRESS 3138 E. MIN ST <br /> SIQCKTON CA- <br /> OILING ADDRESS VIRGINA HOLT, 823 WINDSOR, STOCKTON CA. 9520 <br /> 1 . Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at facility @ S150. 6/ w <br /> b. Additional Tanks (f / Additional Tanks x $50) <br /> 2. State Surcharge (per tank) (Due with Permit Application. I <br /> on renewal or amendment of operation permit and temporary closure) <br /> 456 x Total A 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 /> (I_ Temporary closures x $80) (See above f3 to calculate surcharge) <br /> 4. *Permanent Closure (per tank) Underground Storage Tank in which <br /> storage has ceased and where the owner/operator has noY MtZeeNr <br /> PA <br /> of re-using tank . RECEIVED <br /> (l Permanent Closures x $90) AUG 01968 <br /> 5. Plan Check Fee $30. j NVIRONMENTAL HEALTH <br /> PERMITISERVICES <br /> Total Number of Tanks <br /> / Total Fee Due <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check, <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (I regular. 1 unleaded. 1 supreme. I waste oil ) 6150 <br /> Ia. Existing Facility 6 1st Tank <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x S56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> ' •Orth closures will be conditionic <br /> ed. Contact a Health Distrt Representative. I <br />