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FEE WORKSHEET PER EACH FACILITY ../ <br /> FACILITY <br /> DBA �yy�� %/%ixa / r��Gii�� ADDRESS V/.2 <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facilitv @ $150. <br /> b. Additional Tanks (b 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 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 /> (1'_ Temporary closures x $80) (See above 03 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 /> (R_ Permanent Closures x $90) C'21eFO f� <br /> 5. Plan Check Fee $30. <br /> Total Number of Tanks Total Fee Duey <br /> 87 <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, I supreme, 1 waste oil ) <br /> Ia. Existing Facility 8 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 /> `Doth closures will be conditioned. Contact a Health District Representative_ <br /> /A Q 7 31 <br />