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FEE WORKSHEET PER EACH FACILITY / �,{ , <br /> DBA ADDRESS Y A" / <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual Inspection Fee ��✓7�t ��� <br /> a. First Tank at Facilitv @ $150. �, v <br /> b. Additional Tanks (M 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 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 /> (/ Temporary closures x $80) (See above /3 to calculate surcharge) <br /> 4. "Permanent Closure (per tank) Underground Storage Tank in which <br /> storage has ceased and where the gwner/operator has no intent <br /> of re-using tank , L� <br /> (N Permanent Closures x $90) z <br /> 5. Plan Check Fee $30. <br /> // Od <br /> Total Number of Tanks Total Fee Due `s <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check , <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> ( 1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x 556 224 <br /> Total Number of Tanks 4 Total Fee Due 5524 <br /> *Both closures will be conditioned. Contact a Health District Representative. r <br /> r CY r� IN T ,� <br /> Z-:V, <br /> 0CS al <br />