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FE R, SHEET <br /> DBA, 1 ._ <br /> a <br /> A DRESS <br /> l: New Facility or Addition <br /> a, First'Tank;$180'. <br /> b. Additional Tanks ,{ Additidnal. Tanks x $60) - <br /> 2 Operating Pe it 'Application/Annul 1 spe ti6,n Fee <br /> a Existing Eaci.lity: and 1st Tank '$1: <br /> b. Additional' Tanks ,,,(,# '�Add.it,f'nal Tams x;$50) <br /> 3. State Surcharge (per tank) ;(Due with Permit Application, <br /> on renewal or amendment of operation permit) <br /> ($56 x Total # Tanks} <br /> . *Temporary Closure (per% tank;) lJnde`rground $forage Tank in which <br /> storage has ceased :bult= vh re the owner/operator proposes o <br /> re-use tank within, 2' years.' <br /> ( ''Tem poralr ;e16suses, x $80)' <br /> 5: *Permanent Closure (per tank;) Und aground Stor'age Tank in Which <br /> storage has ceased and where the owne /pperater �has no intent <br /> of re-using 'tank within next 2 years. <br /> (# Permanent Closures x, $90) <br /> Total Number of Tanks,', Total Fee Due <br /> Make all fees payable to $ rx Joaquin Ltrcal -Hea1:tb :istrict. Enclose this worksheet <br /> with your check <br /> EXAMPLE —Annual ;Fee for ,faci 1 it ! wi th 4 Tion s <br /> (1 regular, l unleaded I suprome, 1 waste oil ) <br /> 3a. Existin Facility 1st Tank $150 <br /> o. 8 Addi i anal, Tanksx,: 5E 150 <br /> 2.: State Surdfarge, 4�Taps rc $ 6 224 <br /> Total Nitber` of Tanks 4 Total Fee t3ue $524 <br /> h <br /> *Both closures will 'betndltioned c a:Health istrict,R resentative " <br /> - <br />