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E.MORKS:{CET PER EACH FACILITY .AW <br />fACILITY r �. <br />,A M n 1n F,C1cr ADDRESS <br />.MING ADDRESS 1 4 L/ /II</✓T/C,e. ,4 c cTor/A=1 <br />Operating Permit Application/Annual Inspection .Fee <br />a. First Tank at Facility @ 1150. <br />b. Additional Tanks (/ 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 />(156 x Total N Tanks) <br />`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 />(f_ Temporary closures x $80) (See above f3 to calculate surcharge) <br />'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 />(f-_ Permanent Closures x 190) <br />S. Plan Check Fee 130. <br />Total Number of Tanks CABs Total fee Due <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, 1 waste oil) <br />Ia. Existing Facility b 1st Tank $150 <br />b. 3 Additional Tanks x 150 150 <br />2. State Surcharge, 4 Tanks x $56 224 <br />Total Number of Tanks 4 <br />Total Fee Due 1524 <br />*Both closures will be conditioned. Contact a Health District Representative. <br />910 <br />