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930 Blue Gentian Rd - Additional SAC Fee For Waste Discharge Rules't Metropolitan Council SAC PAYMENT FORM The Metropolitan Council Environmental Services has determined that Company Name: ReyHan PGF Facility Address: 930 Blue Gentian Rd Community: Eagan the community listed above is required to obtain 1 metropolitan Sewer Availability Charge (SAC) unit at the 2012 rate of $2,365 per unit for an increase in the wastewater demand to the Metropolitan Disposal System. Payment of the applicable SAC is a Permit Condition described in Section 205.00 of the "Waste Discharge Rules for the Metropolitan Disposal System." Payments shall be made with this form to the community in which the above facility is located. Note: Payment of SAC does not relieve permitted industries of additional charges that may be assessed by communities for an increase in the wastewater demand through the local sanitary sewer. 1 verify that has paid 3 5 SAC units on Signed Total metropolitan amount due: $2,365.00 by 3/31/12 Representing: CAI of- Ec c VERIFICATION OF PAYMENT To be completed by community official (communit ' ame) (name of permitted industry) 3 2oi (date) wticw•.metrocounci1.org Permit Number: 1423 Environmental Services Title: 0- l Ce Y\1 t s � f' (title) s , SARAH JEAN BRANDEL Notary Public- Minnesota vwwwzy.45,wwwwommission Expires Jan Distribution: The community of Eagan should retain a copy of this signed form. ReyHan PGF should retain the original and send a copy to Metropolitan Council Environmental Services, Industrial Waste & Pollution Prevention, 390 N Robert St, St Paul, MN 55101 -1805. Thank you. revised 11/15/2010 390 North Robert Steet • St. Paul, MN 55101 -1805 • (651) 602 -1005 • Fax 602 -1138 • TTY Y 291 -0904 .4n Equal Opportunity Employer City of Eagan Cash Receipt Receipt Date 3/16/2012 Receipt Number 178028 REYHAN /CK #180000625 SAC FEES 9220.2275 930 BLUE GENTIAN RD *Total Receipt Amount 121197 6:44:30 2,365.00 2,365.00