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EE wOWSHCET PER EACH FACILITY <br /> FACILITY <br /> AAORESS <br /> AILINi AOORESS 'IA S C4tAv'� <br /> . Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @4150. <br /> b. Additional Tanks (i Additional Tanks x $50) <br /> State Surcharge (per tank) (Due with Permit Application. <br /> on renewal or amendment of operation permit and. temporary closure) <br /> ($56 x Total I Tanks) <br /> • *Temporary Closure (per tank) Underground Storage Tank in which PAYMENT <br /> storage has ceased but where the owner/operator proposes to R E C E► V E D <br /> re-use tank within 2 years. NOV ' 3 ,cup, <br /> (I, ^_-Temporary closures x $80) (See above 03 to calculate sureharge) <br /> . *Permanent Closure (per tank) Underground Storage Tank in which ENVIPERMMENLgL HEALTH <br /> storage has ceased and where the owner/operator has no intent Ee icEs <br /> of re-using tank . �y <br /> a <br /> (/" Permanent Closures x $90) <br /> Plan Check Fee $30. <br /> A <br /> Total Number of Tanks Total Fee Due q0 <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> kith your check. —�� <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> ( 1 regular. 1 unleaded, 1 supreme. 1 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 Totai Fee Oue $524 <br /> *69th closures will be conditioned. Contact a Health District Rive. <br /> 7 a!r, <br />