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CEE WQRKSHEET PER EACH FACILITY FACILITY <br /> DBA City of Lodi ADDRESS 125 N. StoYon Street <br /> MAILING ADDRESS City Hall , Call Box 3006, Loi , CA 95241-1910 -- <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 Ist 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 /> ($56x 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 43 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 $70) �— <br /> Total Number of Tanks 1 Total Fee Due $ 90 <br /> PAYMENT <br /> Make all fees payable to San Joaquin Local Health District. Enclose ffsCAI'Ks[IERt <br /> with your check. AUG 4 1987 C s <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (I regular, I unleaded, 1 supreme, I waste oil ) <br /> Ia. Existing Facility & Ist 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 /> 2-36 <br />