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! s . • • <br /> FEE WORKSHEET <br /> DBA R=X $X XN1(XXX RICH- FRUIT PAK CO. (formerly RICH-PIK'D RITE INC. ) <br /> P. O. BOX 67 <br /> ADDRESS 19901 So. McHenry Avenue, Escalon, CA 95320 <br /> 1. Operating .Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. $ 150. <br /> b. Additional Tanks (#�_ Additional Tanks x $50) 100. <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit) <br /> ($56 x Total # 3 Tanks) ivU. <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) <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 /> (# Permanent Closures x $90) <br /> Total Number of Tanks 3 Total Fee Due $ 418. <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, 1 supreme, 1 waste oil ) [[i L L;- <br /> la. Existing Facility & 1st Tank 1 Lib. 3 Additional Tanks x $50 t't' <br /> 2. State Surcharge, 4 Tanks x $56AR <br /> NVIRO!`r�t``SERVICEg AL HEALTH <br /> Total Number of Tanks 4 Total Fee Due 152VERIAII"/ <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 12/85 <br /> • <br /> 0 <br />