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FACILITY <br /> DBA Al 5 I <br /> MAILING ADDRESS /�/ �j✓. J�Jf' t QQ <br /> I. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (f 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) <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 /> =a U 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 /> (/—L Permanent Closures x $90) O <br /> 5. Plan Check Fee $30. <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 /> 1A. Existing Facility b 1st Tank $150 7A/� <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-R6 <br /> UG�� al <br />