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WAa <br /> is - <br /> i <br /> ;f <br /> - es-`.to -:r• <br /> _ �r t`�'r:` ro <br /> os <br /> he`owner�o�-e a o ;tis =:�: <br /> •'`il `story ej ^hasl_ceased_.6ut`where.-t / P P P <br /> i <br /> :•e.. <br /> s;r: : _ <br /> 1 .ji <br /> ,f" <br /> F - <br /> r <br /> ., <br /> �'J �'Y ori <br /> Y - <br /> h'n. ea s�. <br /> it z <br /> �u e' taR �w 4 <br /> re� s k<: - _ <br /> y <br /> = : <br /> :. . rt.: <br /> .: ;� ,.: <br /> r .: �,.: <br /> r:: <br /> fir.: _ .�.•. <br /> tY .t.a.F - <br /> F <br /> +1�- ;'y7 _(#` :-Temporary clo'sures:'x<'$80) - t _ s <br /> 4. *Permanent Closure (per. tank} Underground StoragerTank-in which• c � • <br /> 4 <br /> BIZ-' - storage has ceased and where the owner/operator has. no intent:• '' <br /> y' Wi - . _ F <br /> �` of re using tank within next 2-years _ <br /> ' <br /> y;-�",f � _' :Permanent Cl osures x .$90) = F t �D.SdZ <br /> Yt'r .. - I.;- <br /> ` dy_o <br /> `; Total Number of Tanks Total Fee Due _ , � <br /> . :71 . <br /> ,..:-A• �. x. 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':5:�->_ .� R:.�ti .�_' ,.F.�->.. <br /> $w +�'2 .Q_4'. , , Su.rchar. e;::� Tanks:x:'$56 �,.: J�� .... ;F,_:22 ;., ` = :M> : -��•, .:n <br /> F:�" � •. ^:'c is +rZ;t {9 Ry�viat. -,;, crw ,f5i,- :t:..f:c. ^.sr�a{i+c} <br /> e�"+ i,., .::yam. ::�:� €: <br /> 1 ...,r , �:; . ,; . - is; :ri. - , ;:;w .., ::� ., <br /> ..A. stir ;�'. pv' •..;":'"�'' �: :ti-.:{. Y. <br /> '. •"r, : :5: 'i11. �. .�.#":yi;' -,�yi. .K' .r.'•'i',N - - iP ,, }'::'� .V. s, .5 <br /> r:4 <br /> y,j; <br /> 4. 't.4 <br /> _.h <br /> t;+ <br /> _ w� <br /> �a .�� iay <br /> 'i <br /> 6. <br /> Wit- <br /> f- <br /> A <br /> , .�....:; T '1•:Fee Due ", 5�4 ;r_,-:1, <br /> ii;. ' ,; >-' A: 'Total.,Number of. Tanks -4 _ Tot $ •.a <br /> A.:. <br /> �,;.' n <br /> �+'-» <br /> 'i <br /> � _-e <br /> '-.,.W.� <br /> *Both-closures will. be 'conditioned Contact a Health-District`Representative .' _, `- <br /> 12/85 11 <br /> r i� .r 5 <br /> i L \ t' <br /> y A'_ ' �ur - z9 y <br /> . ., . _:A. <br />