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FEE uORKSHCET PER EACH FACILITY 0 • <br /> FACILITY <br /> DBA _ /Q(�y /��a.y� ADDRESS <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (/ 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 N 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 /> (l. Temporary closures x $80) (See above f3 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 /> A� <br /> Permanent Closures xf901 <br /> � <br /> S. Plan Check Fee $30, <br /> A <br /> dG <br /> Total Number of Tanks Total Fee Due <br /> Make all fees payable to San Joaquin Local Health District. Enclose this workoA4 MEN T <br /> with your check. RECEIVED <br /> NOV I (; 1787 <br /> ENVIRONMENTAL HEALTH <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks PERMITISERVICES <br /> ( 1 regular, I unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility b 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x SS6 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> 'Both closures will be conditioned. Contact a health District Representative. <br />