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rEE WORKSIiLET PER EACFI FACILITY <br /> FACILITY <br /> DBA LAMORE REPAIR ADDRESS 3.138 E. NAIN ST <br /> MAILING ADDRESS VIRGINA HOLT, 823 WINDSOR, STO=N CA. 9520 <br /> 1 . operating Permit Application/Annual Inspection .Fee _ <br /> a. First s Tank at Facility @ <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 03 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 InteTt <br /> PAYMET <br /> of re-using tank. RECEIVED <br /> 7 <br /> (/ Permanent Closures x $90) AUGV 0 1988 <br /> 5. Plan Check Fee $30. ENVIRONMENTAL HEALTF{ <br /> PERMIT f SERVICES <br /> 0�2`, 6, <br /> Total Number of Tanks Total Fee Due <br /> COLLEGE SQUARE OFFICE 7 15 E <br /> P.O.BOX 588,STOCKTON,CA 95201 <br /> WELLS FARGO BANK <br /> P.O.BOX 7237,CAPISTRANO BEACH,CA 92624-7237 STO KT O 210 A 453 207 <br /> NORTH CALP.O.BOX 214608,SACRAMENTO,CA 95621 <br /> CONSTRUCTION <br /> DATE AMOUNT <br /> ,�%'m�%:�*:;:$296 dollars and no Gents% <br /> ,�,�;;�;;��;� �< 08/30/88 -,!n'c$296.00 <br /> PAY <br /> TO THE <br /> ORDER <br /> OF: San Joaquin. County Local Health j <br /> r _ <br />