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FEE WORKSHEET 4 <br /> DBA EAST-SIDE WINERY <br /> ADDRESS 6100 E. Highway 12, Lodi, CA 95240 <br /> 1• Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. <br /> b. Additional Tanks (# , $150.00 <br /> Tanks x $50) $150.00 <br /> 150.00 <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit) <br /> 0556x Total ' # 4 Tanks)— 224.00 <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 /> (# 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) <br /> Total Number of Tanks <br /> 4 Total Fee Due $524.00 <br /> 1 unleaded <br /> 3 diesel <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet Q / <br /> with your check and the completed application. <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (1 regular, .l unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Facility & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 <br /> 2. State Surcharge, 4 Tanks x $56 24 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> ENVi.f, r,, , I ?16th <br /> kL' . ,, ... ..r . <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 12/85 <br />