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IEE wORKSHEET PER EACII FACILITY <br /> L. c <br /> / lbo �i'�'z�� FACILITY <br /> DBA � ADDRESS 0sro�hra� cA. <br /> 'tAILING ADDRESS " t C•t i:�ifvsTRU <br /> os[ ice Box 588 <br /> Stockton,CA 95201 <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (/ 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 /> (156 x Total A 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 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 /> (1 Permanent Closures x $90) <br /> 5. Plan Check Fee $30. <br /> Total Number of Tanks Total Fee Due <br /> Hake 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 6 1st Tank 1150 <br /> b. 3 Additional Tanks x 150 150 <br /> 2. State Surcharge, 4 Tanks x S56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> ' <br /> *Both closures will be conditioned. Contact a Health Districtepresentetive. <br />