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FEE WORKSHEET PER EACH FACIL <br /> DBA ,SHELL OIL COMPANY FACILITY 6131 PACIFIC AVENUE & PORTER AVENUE <br /> ADDRESS STOCKTON, CA 95207 <br /> MA1,LING ADDRESS p .0. BOX 13678 , SACRAMENTO, CA 95853 <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $15n. N/A <br /> b. Additional Tanks (f Additional Tanks x $50) N/A <br /> 2. State Surcharge (per tank) (Due with Permit Application. <br /> on renewal or amendment of operation permit and temporary closure) <br /> (156 x Total N Tanks) N/A <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) N/A <br /> 4. *Permanent Closure (per tank) Underground Storage Tank in which <br /> storage has ceased and where the owner/operator has no intergA y M ENT ' <br /> of re-using tank . RECEIVED <br /> (>r Permanent Closures x $90) Ft 9N/A <br /> � 18,E <br /> 5. Plan Check Fee $30. N9g DISPENSERS ENVIRON $30.00 <br /> MENTAL HEALTH <br /> "'IM,+T/SERVICES <br /> Total Number of Tanks EXISTING' Total Fee Due $30.00 <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 , I waste oil ) <br /> la . Existing Facility b 1st Tank SI`'JO <br /> b. 3 Additional Tanks x $50 1`,J0 <br /> 2. State Surcharge , 4 Tanks x $56 2?4 <br /> Total Number of Tanks 4 Total Fee Due S`�?. <br /> 'Doth closures will be conditioned. Contact a health District <br /> 1—Representativ <br /> --- ----- t e. <br /> 2-86 <br /> UGT al <br />