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=EE WORKSHEET PER EACH FACILIO <br /> FACILITY <br /> C <br /> AA �.����-�t� ADDRESS 3/ <br /> WILINi' ss <br /> . Operating Permit Application/Annual Inspection Fee <br /> a. Furst Tank at Facility @ $150. <br /> s; b. Additional Tanks (I Additional Tanks x $50) <br /> . ''State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and. temporary closure) <br /> ($56x Total / Tanks) <br /> • "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) (See above /3 tq calculate surcharge) <br /> • "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, I / <br /> (r/ Permanent Closures x $g0) <br /> Plan Check Fee $30. <br /> Total Number of Tanks Total Fee Due <br /> take all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> pith your check. <br /> EXAMPLE - Annual 'Fee for Facility with 4 Tanks <br /> (1 regular, l unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility 6 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 /> �y <br /> 80th Closures will be-conditioned, Contact a Health District Representative. <br /> "►" ' .21 <br />