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0 <br /> FEE WORKSHEET <br /> DBA Tri le E Produce Cor oration <br /> ADDRESS 8690 W Tjinne Rd mailing address: P.O. Box 473, Tracy, Ca. 9537-8- <br /> 1. New Facility or Addition <br /> a. First Tank $180. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> >. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. $150.00 <br /> b. Additional Tanks (# �i Additional Tanks x $50) 501-0 <br /> 3. 'State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit) <br /> (S56 x Total "_— Tanks) 1 1-2,0a- <br /> 4. <br /> -2004. *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) <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-using tank within next 2 years, <br /> (= Permanent Closures x $90) <br /> Total Number of Tanks 2 Total Fee Due $312.00 <br /> "fake 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 & lst Tank ft j] <br /> b, 3 Additional Tanks x $50 1+1 <br /> 2. State Surcharge, 4 Tanks x $56 0 <br /> 4 <br /> �a--1-H 18 1986 <br /> Total Number of Tanks 4 Total Fee Due E4OMENTAL HEALTH <br /> FERMIT/SERVI ES TH <br /> *Both closures will be conditioned Contact a Health District Representative. <br /> 1-86 0 40 <br />