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FEE WORKSHEET PER EACH FACILITY <br /> L.�/ FACILITY ,� <br /> DBA Stockton Nissan ADDRESS 1847 N. Wilson"�1ay, Stockton, Ca. 95205 <br /> MAILING ADDRESS P. -0. Pox 8850, Stockton. Ca. _95208 T <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. Z-5--Z) <br /> b. Additional Tanks (# 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 # ,2, Tanks) //Y- <br /> 3. <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. LL - <br /> (# Temporary closures x $80) (See above #3 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 /> (# Permanent Closures x $90) <br /> /Y.ac <br /> Total Number of Tanks Total Fee Due �� <br /> Make all fees payable to San Joaquin Local Health District. Enclose thisrc�r 0T, <br /> with your check. RECEIVED <br /> OCT 2 Q- 9.86 <br /> EXAMPLE - Annual Fee for FacilitEo <br /> y with 4 Tanks KVIIQNME TALMJTI <br /> ds <br /> ( 1 regular, I 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 />