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FEE WORKSHEET PER EACH FACILITO 0 <br /> FACILITY S� <br /> DBA ���U ,� � l/ (�.� _ ADDRESS / SSD <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual Inspection fee <br /> JAN 3C' <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (N Additional Tanks x $50) ENVIROMENTAL HEALTH <br /> 2. State Surcharge (per tank) (Due with Permit Application, PERMIT/SERVICES <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 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 /> (N_ Temporary closures x $80) (See above k3 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 /> (H � Permanent Closures x $90) <br /> 5. Plan Check Fee $30. <br /> Total Number of TanksTotal Fee Due <br /> Make 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 /> Ia. 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 <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 2-86 <br /> le n_T -:U1 <br />