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DBA "Ltf FACILITY , <br /> FACILITY <br /> MAILING ADDRESS ADDRESS l is <br /> 1, Operating Permft. <br /> App <br /> a. ' First Tank at Facility lication/Annual Inspection Fee. <br /> ' <br /> b. Additi@ f150, <br /> onal Tanks (/ <br /> 2. State — Additional Tanks x $50) <br /> Surcharge (per tank <br /> on renewal ) (Due with Permit Application, <br /> or amendment of operation permit and <br /> ($56 x Total N Tanks) <br /> temporary closure) <br /> 3' 'Temporary Closure <br /> (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 /> (1—_._ Temporary: closures x S80 <br /> 4' 'Permanent Closure ) (See above /3 <br /> (per tank calculate surcharge) <br /> Underground Storage Tank in which <br /> storage has ceased ) <br /> and where the <br /> of re-using tank •of has no intent <br /> (K---L Permanent Closures x $90) <br /> • Plan Check Fee $30• oo <br /> Total Number of Tanks / <br /> Total Fee Due � �� <br /> e all fees payable to San Joa uin NO& <br /> h your check , Local Health District. Enclose this worksheet <br /> X' MP-LE - Annual Fee for Facility with 4 Tanks <br /> ( l regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> Id, Existing Facility 8 1st Tank <br /> b- 3 Additional Tanks x $50 $150 <br /> 2• State Surcharge, 4 Tanks x $56 150 <br /> 224 <br /> Total Number of Tanks 4 <br /> — Total Fee Due $574 <br /> osures will beconditioned. Contac <br /> _t a Health District Representative. <br />