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BEET <br /> - fl ss, 7 <br /> Ess :37 <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank. @ $150• <br /> b. Additional Tanks (#_J_ Additional Tanks x $50) <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit) 1� <br /> ($56 x Total # '�— Tanks) <br /> p rnf Stft^�9e T�rlk, l Il, whi rh <br /> *T"^norary Cio;ure (Y.r tank) Und_rg. �r�d <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 Fee Due <br /> Total Number of Tanks <br /> Make all fees payable to San Joa uin Local Health District. Enclose this worksheet <br /> with your check too v <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (I regular, 1 unleaded, 1 supreme, 1 waste oil ) $150 <br /> la. Existing Facility & 1st Tank <br /> 150 <br /> b. 3 Additional Tanks x $50 <br /> 2. State Surcharge, 4 Tanks x $56 IV <br /> Total Number of Tanks 4 Total Fee Duer52 i9� <br /> — <br /> F E 8 Z 5 <br /> ENVIROMENTAL HEALTH <br /> *Both closures wi11 be conditioned. Conti a Health District Reprgpkjy VRC£S, <br /> 12/85 q <br />