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FEE WORKSHEET PER EACH FACILITY <br /> FACILITY <br /> OBA Gold Bond Building Products ADDRESS 800 West Church Sc. , Stockton, rA 95203• ` <br /> MAILING ADDRESS 800 West Church St. , Stockton, CA 95203 <br /> 1. New Facility or Addition <br /> a. First Tank $180. <br /> b. Additional Tanks (= Additional Tanks x $50) <br /> 2. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st. Tank @ S150. <br /> b. Additional Tanks (r Additional Tanks x $50) <br /> 3. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> (S56 x Total e Tanks) <br /> �. 'Temporary Closure ..(per tank) Underground Storage Tank. _jn- 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 /> 5. *Permanent Closure (per tank) Underground Storage Tank in which <br /> storage has ceased and where the owner/operator has no intent <br /> of re-usino tank within next 2 years. <br /> (P 2 Permanent Closures x $90) $180 <br /> i <br /> Total Number of Tanks- 2 - Total Fee Due $250 <br /> Bvv*nS--t ($35) JTo'+-- _ <br /> Consultation (�35) <br /> Make all fees payable to San daacuin Local Health District. Enclose this worksheet <br /> with your check. . .. <br /> EXAMPLE - Annual F --- -- JAMES F.FRUMM 273 <br /> (1 regul MARY JANE FRUMM <br /> 3678 MESA VERDES OR. <br /> 1a. Exi EL DORADO HILLS, CA 95630 <br /> 3211 <br /> b. 3 A hie <br /> 2. S to-- ', T `r� �J/•c�l sL 4`'/ o <br /> a- <br /> Total Nur AEROJET CENTER <br /> FEDERAL CREDIT UNION <br /> _ 12519 Falaom BM.Rema CoEM.0 Y3E'IB ^-� <br /> 02 <br /> '30th closures will be "• 73 <br />