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FEE WOkKSHEE1 PER EACH FACILO O <br />DDA Otto V. Herrington <br />FACILITY $r <br />ADDRESS 16 E Harding Way, Stockton, CA <br />MAILING ADDRESS 2000 Alameda De Las Pulgas, San Mateo, CA 94403 <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 (# 2 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 # 3 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 />(# Permanent Closures x $90) <br />95205 <br />150 <br />Total Number of Tanks 3 Total Fee Due $.Op <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 p �� <br />(1 regular, 1 unleaded, 1 supreme, 1 waste oil) <br />la. Existing Facility & 1st Tank $1 APS <br />b. 3 Additional Tanks x $50 150 <br />2. State Surcharge, 4 Tanks x $56 VIR IM ENTAL EALTH <br />F MIT/SERVI <br />Total Number of Tanks 4 Total Fee Due $524 <br />*Both closures will be conditioned. Contact a Health District Representative. <br />2-n6 <br />