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FEE WORKSHCET PER EACIi FA 1,110 J 46 aFAC <br /> DBA . 1/r��(r /1//G� ADORESSY �)y/ d <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual Inspection fee <br /> a. First Tank at Facility @ S150. <br /> b. Additional Tanks (I 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 I 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 13 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 /> (/ QPermanent Closures xs x $9� <br /> 5. ➢� Check Fee SJO. <br /> eh <br /> Total Number of Tanks <br /> Total Fee Due �� C <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, I unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility b Ist Tank 5150 <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 5524 <br /> *Both closures will be conditioned. Contact a Health District Representative. <br />