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FEE WORKSHEET <br /> DBA VALLEY VOLKSWAGEN, INC. ---- — <br /> ADDRESS 647 E MINER, STOCKTON CA 95202 _-- <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. 150.00 <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) <br /> ($56 x Total # 1 Tanks) 56.00 <br /> Underground Storage Tank in which <br /> v. *Temporary Closure (per tarin) .. <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 1 Total Fee Due 206.00 <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 /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Facility & ist 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 (� <br /> ��1.7�+Y tU <br /> FEB 3 <br /> lJab <br /> *Both closures will be conditioned Contact a Health District Reprep EAL HEALTH <br /> PERMITJS�V�CES <br /> 12/85 <br />