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FEE WORKSHEET <br /> DBA Holt Bros. <br /> ADDRESS 1521 W. Charter Way, Stockton, CA 95206 <br /> MAILING : P.O. Box 8130, Stockton, CA 95208 <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. $ 150.00 <br /> b. Additional Tanks (# 9 Additional Tanks x $50) 450. 00 <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit) <br /> AMC x Totai n 10 Tan n$j --S60-.H <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 /> (# q Temporary closures x $80) <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 within next 2 years. <br /> (#_J_ Permanent Closures x $90) _- <br /> Total Number of Tanks 10 Total Fee Due $1, 160. 00 <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check and the completed application. <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Facility & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total_ Number-of_Iank--z -4-.- -- -- -- Tot-&I-Fee ^ $a24 <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 12/85 <br />