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�a \J i ,0,J�, L_ , <br /> -FEE WORKSHEET PER EACH FACILI14 `!an AW Flementary School <br /> FACILITY 21051 E. Hinhway 120 <br /> DHA ADDRESS F.scalon, Calif. 95320 <br /> MAILING ADDRESSFSCAI01,J U'CI1�It'!, L DISTRICT, 1520 Yosemite Ave. Escalon, Ca. 95320 <br /> 1. New Facility or Addition <br /> a. First Tank $180. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> 2. Operating Peniit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. 150.00 <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 # 1 Tanks) 56.00 <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 /> Total Number of Tanks 1 Total Fee Due 206.00 <br /> i <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 /> la. Existing Facility & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 22 <br /> Total Number of Tanks 4 Total Fee Due $52y%MAR 2 5 1980 U <br /> ENVIROMENTAL HEALTH <br /> *Both closures will be conditioned. Contact a Health District RepresentatiyelT/SERVICES <br /> 2-86 <br />