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`WILD FACILITY 3049 W. 12 <br /> :, <br /> � ADDRESS <br /> RAILING ADDRESS <br /> 3049 W. Hwy 12 Lodi, CA. 95242 <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (I 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 Total 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 /> (1 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 /> 090,00 <br /> (t 1 Permanent Closures x $90) <br /> 5. Plan Check Fee $30. <br /> Total Number of Tanks 1 Total Fee Due 4 46- e(1 <br /> 4400*498 <br /> Make all fees payable to San Joaquin Local Health District. Enclose tlolk mAq <br /> with your check, <br /> RECEIVED <br /> DEC 1 � 1988 <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks .ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> (1 regular, 1 unleaded, 1 supreme. I waste oil ) <br /> Ia. Existing Facility & Ist Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x 356 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> "Both closures will be conditioned. Contact a Health District Representative. <br /> EH 23 032 2/86 <br />