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FEE WQPKSHLET PER EACH FACILITY _ <br /> 06A IJ�SC, '05)D' ADDRESSY fl(PSCL <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual Inspection Fee 4.5- ) <br /> a. First Tank at Facility @ $150. t4 � <br /> b. Additional Tanks (I 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 I 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 /> (I_ 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 intent <br /> of re-using tank, <br /> (I ) + Permanent Closures x $90) <br /> 5. Plan Check Fee $30. d —` <br /> Total Number of Tanks Total Fee Due <br /> TA - tl ISrJ P- u�z��isza�,� 1 �K , I-� <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check. <br /> o <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks 14 <br /> 0 regular, 1 unleaded, 1 supreme, 1 waste oil ) �l of _ <br /> Ia. Existing Facility 8 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 6 , �p�pp <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> *Both closures will be conditioned. Contact a Health District Representative. I <br /> EH 23 032 2/86 <br /> � � <br />