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• FEE WORKSHEET PER EACH FACILITY <br /> . <br /> DBA FACILITY <br /> ADDRESS <br /> AILING ADDRESS <br /> v <br /> 1- Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $154. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> -42 State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> r ($56 x Total # Tanks) <br /> 3. *Temporary Closure (per tank) Underground Storage Tank in which <br /> storage has ceased but where the owner/operator oroposes to <br /> re-use tank within 2 years. <br /> (# Temporary closures x $80) (See above #3 to calculate surcharge) <br /> t 1• *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, p <br /> ' (# v Permanent Closures x $90) <br /> 0 w;' Plan Check Fee $30. <br /> r , Total Number of Tanks Total Fee Due <br /> 3 � <br /> "Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> ,with your check. <br /> W � <br /> 4 EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility S Ist Tank $150 <br /> o. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total Number of Tanks 4 Total Fee Due 5524 <br /> r <br /> -*Both closures will be conditioned. Contact a Health District Representative. <br /> 2-86 <br />