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D9 A �- <br />MAILING ADDRESS <br />• FACILITY • <br />ADDRESS %) ICi� �- <br />1• Operating Permit Applicat r'-1 F / (; <br />�uli/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 <br />(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 <br />(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 />(a _ Temporary closures x $80) (See above b3 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 />(#--L Permanent Closures x $90) <br />5- Plan Check Fee $30. <br />Total Number of Tanks <br />Total Fee Due <br />Make all fees payable to San Joa uin <br />with your g Local Health District Enclose this worksheet <br />check <br />EXAMPLE - Annual Fee for Facility with 4 Tanks <br />(1 regular, 1 unleaded, 1 supreme, 1 waste oil) <br />la- Existing Facility 8 1st Tank <br />b- 3 Additional Tanks x $50 <br />2. State Surcharge, 4 Tanks x $56 <br />Total Number of Tanks 4 <br />th closures wil <br />r =, <br />be conditioned <br />$150 <br />150 <br />224 <br />Total Fee Due 5524 <br />t a Health District Representative <br />U6 -F a I • • <br />L <br />