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0 0 <br /> FEE WORKSHEET PER EACH FACILIT <br /> •/` � FACILITY <br /> DBA 7� ^F�(7/c ADDRESS <br /> MAILING ADDRESS <br /> 1. _Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (/ 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 N 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 /> (/ Temporary closures x $80) (See above /3 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 /> ofre- sing tank, <br /> (A Permanent Closures x $90) <br /> 5. Plan Check Fee $30. - <br /> Total Number of Tanks Total Fee Due <br /> R E � <br /> Make all fees payable to San Joaquin Local Health District. Enclose this#r <br /> with your check. <br /> P,1AR u'� 1981 <br /> FNV"1 paR�AIT�SERVICESEALTH <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> ( 1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 �� U <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> * loth closures will be conditioned. Contact a Health District Re resentative. <br />