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FEE WORKSHEET <br /> DBA Ie`v So n Svc <br /> ADDS l�3 IJ 54 C4X <br /> Coti�Oc.{ - K�� L�rnc�ev�naH - 9l(c - 464- 3310 I .. " cv ✓�nGrl� <br /> i <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. 15o Go <br /> b. Additional Tanks (#__A7 _ Additional a ks $50) ,pp <br /> 2. State Surcharge (per tank) (Due with Permit pp i tion, <br /> on renewal or am dment of opera 'on p it <br /> ($56 x Total # _ nks) 24,0,cc <br /> 3. *Temporary Closure (per t nk) Undirnr t. age_ Ta in which <br /> storage has ceased but wher -owner ope ator pr poses to <br /> re-use tank within 2 years. <br /> (#_ Temporary closures x $80) <br /> 4. *Permanent Closure (per tank) Undergro d t age Tank in which <br /> storage has ceased and where the owner/o rator has no intent <br /> of re-using tank within next 2 years. <br /> (#_j_ Permanent Closures x $90) eO <br /> Total Number of Tanks Co Total Fee Due <br /> Make all fees payable to San a uin Local Health District. E lose this worksheet <br /> with your check <br /> EXAMPLE - Annual F e for Facility with 4 Tanks \ <br /> (1 reg4 ar, 1 unleaded, I supreme, 1 waste oil ) <br /> la. Existing Facility & lst Tank $150 <br /> b. 3 Additional Tanks x $50 15 <br /> 2. State Surcharge, 4 Tanks x $56 <br /> Total Number of Tanks 4 Total Fee Due $524 FEB 2 5 198b <br /> ENVIROMENTAL HEALTH <br /> FERMIT/SERVICES <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 12/85 <br />