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FEE WORKSHEET. PER EACH FACILITY a 0 <br /> FACILITY <br /> DBA C1arl, Garage & Service StationADDRESS 125 & 145 S Sjjter <br /> MAILING ADDRESS as above <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (B Additional Tanks x $50) <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 x Total M Tanks) <br /> 3. '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 /> (1'_ Temporary closures x $80) (See above N3 to calculate surcharge) <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 , <br /> (# 6 Permanent Closures x $90) <br /> 5. Plan Check Fee $30. <br /> Total Number of Tanks a Total Fee Due <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check. <br /> �-qwz <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks —qo Q <br /> ( 1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 P A 4�RENT <br /> 2. State Surcharge, 4 Tanks x $56 REC2BIIIVED <br /> Total Number of Tanks 4 Total Fee Due 52� 19U' <br /> .ENVIRONMENTAL HEALTH <br /> PERMITISERVICES <br /> `Both closures will be conditioned. Contact a Health District Representative. <br /> 2-P,G � • <br />