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FEE WORKSHEET PER EACH FACILI'l0r' 1.0 <br /> FACILITY <br /> OBA Pacific Meta Corporation ADDRESS 18776 E. B Street , Clements , CA <br /> MAILING ADDRESS P.O . Box 445 , Clements <br /> 1. New Facility or Addition <br /> a. First Tank $180. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> 2. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> 3. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 x Total # Tanks) <br /> 4. *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 #3 to calculate surcharge) <br /> 5. *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 within next 2 years. <br /> (# 1 Permanent Closures x $90) $90 . 09 <br /> Total Number of Tank, 1 Total Fee Due $90.0-1) <br /> Make all feesq ~�� <br /> payablg to San Joaquin Local Health District. Enclose this worksheet <br /> with your check i g 0 �e � Dy✓� I ' n — , <br /> � I��(� V�CJ(��,,�a�-C.�; &" O <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks � � <br /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Facility & 1st Tank $1 <br /> b. 3 Additional Tanks x $50 15 <br /> 2. State Surcharge, 4 Tanks x $56 22 MAR 3 1 19$b <br /> Total Number of Tanks 4Total Fee Due $5M VIROMENTAL HEALTH <br /> — F ERMIT/SERVICES <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 2-86 <br />