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FEE WORKSHEET <br /> DBA Sheldon Oil Company <br /> ADDRESS 3310 East Miner Avenue, Stockton, CA <br /> 95205 <br /> 1• Operating permit Application/Annual Inspection Fee <br /> a. Existing Facility and Ist Tank @ $150. <br /> b. Additional Tanks (# Additional Tanks x $50) $150. 0 <br /> 0 <br /> 2. State Surcharge (per tank �—`i- <br /> (Due with Permit Application, <br /> on renewal or amendment of operation permit) <br /> r(trr, T t,l <br /> 3. *Temporary Ciosure56, 00 <br /> (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 /> Tota] Number of Tanks One <br /> Total Fee Due $206. 00 <br /> Make all fees payable to San Joaquin Local Health District. Enclose this work <br /> with your check and the completed application. sheet <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (1 regular, 1 unleaded <br /> 1 supreme,P 1 waste oil ) <br /> 1a. Existing Facility & 1st Tank <br /> $150 <br /> b. 3 Additional Tants x $50 <br /> 150 <br /> 2. State Surcharge,-.4 Tanks x S56 <br /> � 224 <br /> 1 Total Number of Tanks 4_ Total Fee Due $52 F <br /> CEO X4 <br /> *Both closures will be conditioned. Contact a Health District Re resentative.SENVIfid3 !yb© <br /> iwENTL HEALTH <br /> 12/85 FERMET/SEWICES <br />