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FEE NORKSHCET PER EACI4 FACILITY <br /> FACILITY � / <br /> DBA - �Ttv� � �� <br /> (Gf 79 /C ADDRESS /E eU L <br /> MAILING ADDRESS <br /> I . Operating P t Application/Annual Inspection Fee <br /> a. Firs an at Facility @ $150. <br /> b. ditional nks (M 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 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 /> (1_ Temporary closures x $80) (See above 03 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 /> (f Permanent Closures x $90) <br /> S. Plan Check Fee $30. <br /> Total Number of Tanks Total Fee Due <br /> 97 <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 /> 0 regular, I unleaded, 1 supreme, I waste oil ) <br /> Ia. Existing Facility b 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 -„6 • <br />