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FEE WORK-SiiEEi PER EACH FACILITY <br /> 08A St �I ��`,� i�{ I� ADDRESS Y <br /> HAILING ADDRESS �W&�P_ zi Lp� ¢ l� <br /> 1. Operating Permit Application/Annual inspection Fee <br /> a. First Tank at Facilitv @ $150. <br /> b. Additional Tanks (I Additional Tanks x 150) <br /> 2• State Surcharge (per tank) (Due with Permit Application. <br /> on renewal or amendment of operation permit and temporary closure) <br /> (156 x Total / 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 /> (f._ Temporary closures x $80) (See above i3 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 /> (I I Permanent Closures x 190) j 0, � <br /> 5. Plan Check Fee 130. <br /> Total Number of Tanks Total Fee Due �D <br /> Hake all fees payable to San Joaquin Local Health District. Enclose this i rksheet <br /> PYMENT <br /> with your check . RECEIVED <br /> FEB i lyae <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks NVIRONMENTAL HEALTH <br /> ( 1 regular, 1 unleaded, ] supreme, t waste oil ) PERMIT/SERVICES <br /> Ia. Existing Facility b 1st Tank $iSO <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x S56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 2 -8.6 <br />