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FEE WORKSHLLT PER EACH FACILIT" <br /> � ,/ FACILITY b� <br /> DBA ;y���� j/i7�i�2�il�yl ADDRESS /6r-,2,17 <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (# 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 /> ($56 x Total N 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 /> (N_ Temporary closures x $80) (See above N3 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 /> (# 3 Permanent Closures x $90) a�©. <br /> 5. Plan Check Fee $30. <br /> ot�al Number of Tanks Total Fee Due x{70 Qd <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check. <br /> PAYMENT ' <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks RECEIVED <br /> ( I regular, 1 unleaded, 1 supreme, 1 waste oil ) MAY la 1y87 <br /> Ia. Existing Facility & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 15&NVIRONMENTAL HEALT14 <br /> 2. State Surcharge, 4 Tanks x $56 224 PERMIT/SERVICES <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> *Both closures will be conditioned. Contact a Health District Representative. <br />