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FEE WORXSH£LT PER EACH FACILITY, <br /> FACILITY <br /> DBA . ADDRESS <br /> MAILING',ADDRESS <br /> 1.' Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. ,,i Additional Tanks (# Additional Tanks x $50) <br /> 2. State Surcharge '(per tank) (Due with Permit 'Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 x Total # 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 i 2 years. <br /> (# - Temporary closures x $80) (See above #3 to calculate surcharge) <br /> 4. *Permanent Closure (per tank) Underground Storage iTank in which <br /> storage has ceased and where the owner/operator has no intent <br /> of re-using tank. <br /> (# Permanent Closures x $90) <br /> 5. Plan 'Check Fee $30 <br /> Total Dumber of Tanks Total Feed clue <br /> Make all fees <br /> payable to San Joaquin Local Health District. Enclose this worksheet <br /> A <br /> with your check. <br /> CN <br /> EXAMPLE, `- Annual Fee for Facility',with 4 Tanks <br /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Farcility & 1st Tank $1.50 <br /> b. 3 AdditionalTanksx $50' 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> *Seth closures will be conditioned. Contact a Health District Representative. <br /> p 2-86 <br /> a <br />