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EE WORKSHLET PER EACH FACILITY • 0 <br /> FACILIT <br /> — <br /> DBAAODRESSY <br /> rx2 <br /> MAILING ADDRESS <br /> 1. , .Operating Permit Application/Annual Inspection Fee <br /> a. First',Tank at Facility @ $150, /S-Q <br /> 'b. Additional Tanks(/ Additional Tanks x $50) c <br /> 2. State Surcharge (per tank) (Due with Permit Application, f <br /> on renewal -or amendment of operation permit and temporary closure) <br /> (S56 x Total l--. _ Tanks) \ 5 <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 /3 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 /> (/4; Permanent Closures x $90) <br /> 5. Plan Check Fee $30. <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 /> PAYMENT <br /> RECEIVED <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks J U L 0 198 <br /> ( 1 regular, 1 unleaded, l supreme, 1 waste oil ) <br /> la. Existing Facility b 1st Tank $150 ENVIRONMENTAL HEALTH <br /> b. 3 Additional Tanks x $50 150 PERMITISERVICES <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 /> 2-86 <br />