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FEE WORKSHEET <br /> DBA Jim Turner , Inc. <br /> ADDRESS 123 S. Main Street , Manteca, Calif . 95336 <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. 150.00 <br /> b. Additional Tanks (# 1 Additional Tanks x $50) 50.00 <br /> $� State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit) <br /> ($56 x Total #__L_ Tanks) 112.00 <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 /> (#_ 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 Number of Tanks 2 Total Fee Due 119 . 00 <br /> Make all fees payable to San Joa uin 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 /> la. Existing Facility & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 gp W EI <br /> Total Number of Tanks 4 Total Fee $524 (� <br /> - <br /> F E 8 5 1986 <br /> ENVIROMENTAL HEALTH <br /> *Both closures will be conditioned Contact a Health District Af*V4 M%P <br /> 12/85 <br />