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FEE WORKS-;CET PER EACH FACILITY <br /> FACILITY G /O <br /> DBA ADDRESS L�� y y <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual Inspection Fee Otto)P 9 <br /> a. First Tank at Facility @ $150. �U1 G �w <br /> b. Additional Tanks (N Additional Tanks x $50) wylpp 1988 <br /> FfRM Tf NrA� <br /> 2. State Surcharge (per tank) (Due with Permit Application. Ty <br /> on renewal or amendment of operation Permit and temporary closure)/3fRVC <br /> ($56 x Total M 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 13 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 intent <br /> of re-using tank _ <br /> (# Permanent Closures x $90) <br /> 5. Plan Check Fee $30. <br /> Total Number of Tanks Total Fee Due <br /> J��/ <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> / <br /> with your check. �GIV <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> ( 1 regular, I 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 $56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 2-1!6 <br /> OC--T- '7f <br />