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FEE WORKSHEET <br /> DBA Bob ' s Muffler & Rabiator , 466 Moffat Blvd. , Manteca , CA _ <br /> AiIDRE.SS_Owner: Walter E. Barbour, 913 Farkwood Dr. , Modesto , CA <br /> 1. New Facility or Addition <br /> a. First Tank $180. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> 2. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> 3. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit) <br /> /fGFr i • 1 <br /> > I o L'a Ta/rks <br /> 4. *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 /> (r_ Temporary closures x $80) <br /> 5. *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 /> (= 3 Permanent Closures x $90) No state surcharge is needed. $270 .00 <br /> Total Number of Tanks 3 Total Fee Due $270 . 00 <br /> Make all fees payable to San Joaquin 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 /> Ia. Existing Facility & 1st Tank $150' <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> r� F: iAL NcFlLTH <br /> Total Number of Tanks 4 Total Fee Due $524 Ett.J!i/SERVICES <br /> *Both closures will be conditioned Contact a Health District Representative. <br /> 1-86 <br />