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60 <br /> FEE WORKSHEET <br /> DBA Moorman Manufacturing Company <br /> of California Inc. <br /> ADDRESS <br /> 250 East Roth Road Lathrop, California 95330 <br /> 1. Operating Permit Application/Annual Inspection Fee $150.00 <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) 112.40 <br /> # 2 T t,' <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. 0 <br /> (# 0 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 /> (# 0 Permanent Closures x $90) n <br /> Total Number of Tanks 2 Total Fee Due $312,Q4 <br /> Q� <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, I 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 2 <br /> Total Number of Tanks 4 Total Fee Due $52 <br /> FEB 18 <br /> ROM <br /> ENVIENRVICEESStH <br /> *Both closures will be conditioned. Contact a Health District RepresentatWM17/SE <br /> 12/85 <br />