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FEE WORKSHEET PER EACH*#m.nCIL1T,*e <br /> FACILITY <br /> DBA i/ �c oc�a.�� ✓ions ADDRESS <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. JAN 1 61987 <br /> b. Additional Tanks (N Additional Tanks x $50) ENVIROMENrAL H <br /> 2. State Surcharge (per tank) (Due with Permit ApplicationpERMlr/SERV10 SETH <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 x Total # 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 /> (H_ Temporary closures x $80) (See above N3 to calculate surcharge) <br /> 4. *Permanent Closure (per tank) Underground Storage Tank in which ,t <br /> storage has ceased and where the owner/operator has no intent'pY tA V V D <br /> of re-using tank , Ftscs <br /> (N� Permanent Closures x $90) 19a1 ���� <br /> 5. Plan Check Fee $30. �Nv\p�RM jISER�ICESC(N ) <br /> Total Number of Tanks 11Z Total Fee Due a U <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, I supreme, 1 waste oil ) <br /> Ia. 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 /> U 6T a f <br />