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FfE WORKSHEET PER EACH FACILITY ` • Dct ,. -� �'< <br /> fACILITY <br /> ADDRESS <br /> MAILING ADDRESS <br /> 1. Operating Permit <br /> p g Application/Annual Inspection Fee < <br /> a. First Tank at Facility @ $150. <br /> �h - <br /> b. Additional Tanks (1'� Additional Tanks x S50) � � `'/ <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> (S56 x Total K 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 /> (/_ 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 gwner/operator has no intent <br /> of re-using tank, <br /> (N Permanent Closures x $90) PAYMENT <br /> RECEIVED <br /> S. Plan Check Fee $30. / P 0 <br /> DEC 1 1988 <br /> ENVIRONMENTAL HEALTH <br /> Total Number of Tanks PERMITISERVICES Total Fee Due V 7,Q <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check, <br /> C\ <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> ( 1 regular, 1 unleaded, 1 supreme, I waste oil ) <br /> Ia. Existing Facility & 1st Tank 5150 <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-.'6 <br /> OC-7- ai <br />