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1 <br /> rEE WORKSHEET <br /> DBA All State Packers, Inc. <br /> p. 0. Box 350, Lodi, Ca. 95241 <br /> ADDRESS <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> 150.D0 <br /> a. Existing Facility and 1st Tank @ $150. 50.00 <br /> b. Additional Tanks (# 1 Additional Tanks x $50) -- <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit) 112.00 <br /> ($56 x Total tt 2 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 /> (# Temporary closures x $80) <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 within next 2 years. <br /> (#_ Permanent Closures x $90) <br /> Total Number of Tanks 2 Total Fee Due 1i2_nn <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check and the completed application. <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Facility & 1st Tank $150 <br /> b.. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total Number of Tanks -4 Total Fee Due $524 JAN 2 1 <br /> ENVIROMENTAL HEALTH <br /> FERMIT/SERVICES <br /> *'Both closures will be conditioned. Contact a Health District Representative. <br /> 12/85 9 0 <br />