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FEE WORKSHEET <br /> DBA J. S. G. Trucking Company <br /> ADDRESS 19400 Horth Highway 99, Acampo, Calif. 95220 <br /> I. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and lst Tank @ $150. <br /> b. Additional Tanks # -^, $150.00 <br /> ( Additional Tanks x $50) 200.'00 <br /> 2. State Surcharge (per tank) (Due with, Permit Application, <br /> on renewal or amendment of operation permit) <br /> (kCr <br /> x T�t�l Tk 2UQpp/�•C!/� <br /> \w..... a uri0 <br /> 3. Temporary Closure (per tank) Undernround 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) <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 within next 2 years. <br /> ( Permanent Closures x $90) <br /> Total Number of Tanks <br /> Tota] Fee Due $630.00 <br /> a` <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check and the completed application. <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility & lst 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 /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 12/85 <br />