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a, <br /> FEE �tv'4�i SHEr.T } �� � � <br /> a FRANK 29 < <br /> MAXPROP. OWNER ED CARDOZA x <br /> 183 N. Main ST <br /> 290 N. Main St <br /> Manteca Ca 95336 <br /> ADDRESS= ' Manteca, California 95336' <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $1500 <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 /> (�6 x Total #_ <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. rs4 <br /> -, <br /> (# Temporary closures x $80) <br /> r <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 /> (P� Permanent Closures x $90) 41 <br /> Total Number of Tanks Total Fee Due �? <br /> s <br /> Make all fee's payable to San Joaquin Local Health District. Enclose thislwork$heet <br /> withy our check and the completed application. <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks r <br /> (1 regdlar, 1 unleaded, 1 supreme, 1 waste oil) `' <br /> la. Existing Facility & lst Tank $150VA 19 <br /> b. 3 Additional Tanks x $50 <br /> 2. State Surcharge, 4 Tanks x $56 <br /> 5 IWO <br /> Total Number of Tanks 4 Total Fee Due $524 1 <br /> ENV1R(3MENTAL HEALTH s <br /> FERMIT/SERVICES <br /> F <br /> *Both closures will be conditioned. Contact a Health District Representative <br /> 12/85 -1 <br /> it &AL <br />