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'f,.-FEE WORKSHEET <br /> p�A Colbarg, Inc. <br /> , ,ADDRESS 401 No. Stockton St. - P.O. Box 1288, Stockton, Cal. 95201 <br /> t;r <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. X50.00 <br /> iP <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit) <br /> --($56 x Total # 1 Tanks) - __. -.---- 56.00 <br /> 3. *Temporary Closure (per tank) Underground Storage Tank in which <br /> i <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 /> (k_ Permanent Closures x $90) <br /> Total Number of Tanks _ 2 Total Fee Due 206.00 <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, l 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 $56 224 <br /> Total Number of Tanks 4 Total Fee Due ���y 0 <br /> FEB 7 1986 <br /> *Both_ closures will be conditioned. Contact a Health District RepresNTAL HEALTH <br /> SERVICES <br /> 12/85 <br />