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i <br /> FEE WORKSHLET PER EACH FACOTY FACILITY <br /> ADDRESS <br /> DBA <br /> �L <br /> MAILING ADDRESS �� � � �i�. <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> Additional Tanks x $50) <br /> b. Additional Tanks (0. Application, <br /> 2. State Surcharge (per tank) (Due with Permit App <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 x Total <br /> Tanks) <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 /> arge) <br /> (# Temporary closures x $80) (See above N3 to calcul which te rch <br /> 4. *Permanent Closure (per tank) Underground Storage h Tank <br /> in <br /> intent <br /> storage has ceased and where the owner/operatorN"r <br /> of re-using tank . p A'j ESV Ep <br /> (y Permanent Closures x $90) R <br /> G <br /> 5. Plan Check Fee $30. <br /> 1981 <br /> �NVIRONMENSERVICES LTH <br /> aI1T�Fee Due ---- <br /> Total Number of Tanks <br /> Make <br /> 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, I unleaded, 1 supreme. 1 waste oil) $150 <br /> Ia. Existing Facility & 1st Tank 150 <br /> b. 3 Additional Tanks x $50 224 <br /> 2. State Surcharge, 4 Tanks x $56 <br /> Total Number of Tanks 4 <br /> Total Fee Due $524 <br /> *Both closures will be conditioned. Contact a Health District R�presentative_ <br /> 2-,�G 0 <br /> • <br />