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y .GLUlfS �� ... <br /> FACILITY <br /> D, G( v hl A �.. <br /> T. <br /> v <br /> 5�;.',. . .. ;.�•,U Kt Fy ADDRESS <br /> r ' Ve <br /> SIL. NG bf}R�SS��; ,+U. �� ;O�r��o 5� ck�b,� tJ� '7452°2- <br /> ... �Operattng Permit Application/Annual Inspection Fee <br /> Fust Tank at Facility @ '$15o. <br /> b Additionalm Tanks ( C.` `Additional, Tanks x $50) rd.' <br /> 2 � State'Surchar'ge`,(per tank) '(Due with Permit Application, <br /> on -renewaWor amendment:of operation permit and temporary closure) <br /> ($56--x Total # Tanks) . <br /> r 3• *TemporaryUnder round Storage Tank in which <br /> Closure: {per tank) 9 g <br /> storage has ceased but where the, owner/operator proposes to <br /> re--use tank within 2 .years. <br /> (I Temporary 'closures x $80) (See above #3 to calculate surcharge) 74. <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 /> (# Permanent Closures x $90) <br /> 5. Plan Check Fee $30. <br /> Total Number of Tanks ( Total Fee Due �o: <br /> r <br /> Make all fees payable to San Joaquin Local Health District. Enc�ose this worksheet <br /> with your check , P ZC <br /> JUL 16 1988 <br /> EXAMPLE - Annual fee for Facility with 4 Tanks 'NVIR NME,�TAL NEA <br /> ( 1 regular, l unleaded, 1 supreme, I waste oil ) r�SERVdCS LTA <br /> la. Existing Facility 1st Tank 5150 <br /> b, 3 Additional Tanks x S50 150 <br /> 2. State Surcharge,-4 Tanks x S56 224 ' <br /> Total Number of TAnks 4 Total Fee Due S5?-4 <br /> *Both closures will be conditioned. Contact e, Health District Representative, <br />