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FState <br /> EET PER EACH FACILITY FACILIT• <br /> � AOORESSY 3000 ORESS S0C9V MGting Permit Application/Annual .Inspection Feerst Tank at Facility @ $150. <br /> dditional Tanks (0 Additional Tanks x $50) <br /> Surcharge (per tank) (Due with Permit Application. <br /> newal or amendment of operation permit and temporary closure) <br /> 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 /> (/_ Temporary closures x_$80) (See above 13 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 intgnt PAYMENT, <br /> of re-using tank, RECEIVED: w <br /> (f 1 Permanent Closures x $90) FEB" 1 6`1988 <br /> 5. Plan Check Fee f30. ENVIRONMENTAL HEALTH <br /> PERMITISERVICES <br /> Total Number of Tanks Total Fee Due <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check, <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> ( I regular, I unleaded, I supreme. 1 waste oil ) <br /> Ia. Existing Facility b 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 $524 <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 2-RG . • <br /> u6T � r <br />