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FEE uORKSHCET PER EACH FACILITY <br /> FACILITY <br /> DBA ADDRESS <br /> MAILING ADDRESS U <br /> f'_ <br /> 9 <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (N 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 /> (b56 x Total M 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 /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 /> C) <br /> (N �( Permanent Closures x $90) <br /> 5. Plan Check Fee $30. <br /> Total Number of Tanks Total Fee Due �� <br /> a JJ <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet 2 <br /> with your check . <br /> EXAMPLE Annual Fee for Facility <br /> with 4 Tanks <br /> ( 1 regular, I unleaded, l supreme. 1 waste oil ) <br /> Ia. Existing Facility G 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 /> BOCK C105urCS will be conditioned. Contact a Health District Representative. <br /> _ <br /> 2-746 <br />