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PLR EACH FACILITY <br /> FACT L I TY 3049 W. H2 <br /> DGAL1J,7ILD ADDRESS <br /> MAILING ADDRESS <br /> 3049 W. Hwy 12 - Lodi, CA. 95242 <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (1 Additional Tanks x $50) <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and. temporary closure) <br /> ($56 x To to l N 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 13 to, calculate surcharge) <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, <br /> 000 <br /> (I a- Permanent Closures x $90) <br /> X9 . <br /> 5. Plan Check Fee $30. <br /> Total Number of Tanks Total Fee Due 4 9©. 60 AWWPW@1 <br /> Make all fees payable to San Joaquin Local Health District. Enclose tto�►WVA T <br /> with your check. RECEIVED <br /> DEC 1 �9d8 <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks ENVIRONMENTAL HEALTHPERMITI SERVICES <br /> ( I regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility b 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge , 4 Tanks x $56 224 <br /> Total Number of Tanks 4 Total Fee Due 5524 <br /> 'Both closures will be conditioned. Contact a Health District Re resentative. <br /> EH 23 032 2/86 <br />