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FEE WORKSHLET PER EACH FACi,`, <br /> FACILITY 1313 EA CHARTER <br /> DBA AIRPORT AND CHARTER ADDRESS STOCKTON, CA 95205 <br /> MAILING ADDRESS 1313 EAST CHARTER, STOCKTON, CA 95205 <br /> I. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. N/A <br /> b. Additional Tanks (/ Additional Tanks x $50) N/A <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 M Tanks) N/A <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) N/A <br /> 4• `Permanent Closure (per tank) Underground Storage Tank in which <br /> storage has ceased and where the owner/operator has no int nt <br /> PAYMENT <br /> of re-using tank , RECEIVED <br /> (M Permanent Closures x $90) FEB 4N/A <br /> -' 1`x'? + <br /> 5. Plan Check Fee $30. $30.00 <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> Total Number of Tanks EXTSTTNG Total Fee Due $30.00 <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, I unleaded, 1 supreme, I waste oil ) <br /> Ia. Existing Facility & 1st Tank 5150 <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 Representative. <br /> 2-86 <br /> UG-r � ( <br />