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LAW hACILITY <br /> DBA .S FACILITY <br /> ADDRESS /32 <br /> MAILING ADDRESS 1-3 -,C; <br /> ,� QG <br /> I. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. /��� <br /> 2 <br /> b. Additional Tanks N-----Additi /SU = <br /> ( onal Tanks x $50) <br /> State Surcharge (per tank) (Due with Permit Application, F� <br /> on renewal or amendment of operation permit and to <br /> ($56 x Total N/ Tanks) mporary closure) <br /> lcr <br /> 3• "Temporary Closure S� <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 /> (N_ Temporary closures x $80) (See above M3 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 reg-using tank , <br /> (#___L Permanent Closures x $90) P E V <br /> 5• Plan Check Fee $30, VtG <br /> 71-1 <br /> -K( <br /> Total Number of Tanks <br /> Total Fee Due 9;1 <br /> /36 <br /> Make all fees payable to San Joaquin Local Health 90 t <br /> %c <br /> with your check . <br /> District Enclose �t <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> 0 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Facility 8 1st Tank <br /> 1). 3 Additional Tanks x $50 5150 <br /> 2• State Surcharge, 4 Tanks x $56 150 <br /> — 224 <br /> Total Number of Tanks 4 <br /> Total Fee Due 5524 <br /> Both closures will be conditioned• Contact a Health District Representative. <br />-R6 — — — <br /> 1-7 l <br />