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FEE dORKSHCET PER ACH FACILITY <br /> ` FACILITY <br /> OBA ApORESS � (� <br /> MAILING AOORESS Z <br /> MENT <br /> �ECEIVE� <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility N $150. mr 12 �aaa <br /> b. Additional Tanks (I Additional Tanks x $50) ER\IIRONMENTPI W '-•'' <br /> 2. State Surcharge (per tank) (Due with Permit Application, PERMITISERVICES <br /> on renewal or amendment of operation permit and temporary closure) <br /> (t56 x Total 0 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 2 years. <br /> (#_ Temporary closures x $80) (See above /3 to, calculate surcharge) <br /> 4. •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. <br /> (1_ Permanent Closures x $90) <br /> S. Plan Check fee $30. Y <br /> Total Fee Due <br /> Total Number of Tanks <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 /> Ia. Existing Facility b 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x S56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 2-A6 <br />