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FEE WORKSHLLT PER EACH FACILITY <br /> FACILITY w„r� <br /> DBA ADDRESS K O. _ KampKronds of America <br /> 2851 East 8 Mile Road <br /> MAILING ADDRESS Lodi, Calif. 95240 <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facilitv @ $150. <br /> b. Additional Tanks (N / 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) I 1 a_ y ' <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 /> (M_ Temporary closures x $80) (See above N3 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 , PAYMENT <br /> (M_ Permanent Closures x $90) REGEIVF-D <br /> S. Plan Check Fee $30. <br /> Nov lg 1986 <br /> ENVIPp�M( ETH <br /> SERVICES <br /> Total Number of Tanks Total Fee Due <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 $56 224 <br /> Total Number of ranks 4 Total Fee Due $524 <br /> "Both closures will be conditioned. Contact a Health District Representative. <br /> 2-},6 <br /> 96-7 j I <br />