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.,NLET PER EACII FACILV <br /> FACILITY <br /> ADDRESS <br /> .,AILING ADDRESS .330 <br /> ' 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (1 Additional Tanks x $50) <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> (S56 x Total I Tanks) <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 13 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 /> (/4 Permanent Closures x $90) a <br /> I <br /> 5. Plan Check Fee S30. <br /> ( <br /> Total Number of Tanks Total Fee Due <br /> s <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 /> ( I ,regular, I unleaded, 1 supreme, 1 waste oil) AUG 15 1983 <br /> Ia. Existing Facility b 1st Tank ENVW#ENTAL HEALTH <br /> b. 3 Additional Tanks x S50 FEN&OT/SERVICES <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 /> .-1 /7 <br /> 2-P.G ��/ Ije_ �Ls/� l <br />