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rLL WUKK•YHLLI PER EACH FACILIT`' <br /> DBA `✓ FACILITY r/ <br /> INDY ELECTRONICS ADDRESS 400 INDUSTRIAL PARK DRIVE <br /> MAILING ADDRESS P.O. Box 2301 MANTECA, CALIFORNIA 95336 <br /> I. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. $ 150.00 <br /> b. Additional Tanks (# 1 Additional Tanks x $50) $ 50"o0 <br /> 2• State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 x Total # ;L, - Tanks) �_b0 <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 /> (#_ Permanent Closures x $90) <br /> 5. Plan Check Fee $30. <br /> 31'a.00 <br /> Total Number of Tanks 2 Total Fee Due gg-gg— <br /> 8/2184 FkIM. K+ O{ foo p0 <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check . 1;41&Ke-e dtge - ' d •00 <br /> AMFLc - Annual Fee for Facility with 4 Tanks — <br /> ( 1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Facility & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 2-86 <br />