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gf� 1 <br /> FEE WORKSHEET PER EACH FACILITY <br /> FACILITY * �a <br /> DBA ADDRESS g" rc° 7 0 <br /> MAILING ADDRESS MANTECA BEAN 00' <br /> P. O. Box I ma—?�9 HdfPa{ <br /> Manteca, Calif. 95330 <br /> 1. New Facility or Addition <br /> a. First Tank $180. <br /> b. Additional Tanks (# Additional Tanksx $50) <br /> 2. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> 3. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) 1 <br /> ($56 x Total # Tanks) <br /> 4. *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 /> 5, ermanent Closure (per tank) Underground Storage Tank in which <br /> i <br /> storage had ceased and where the owner/operator has no intent � <br /> of re-using tank within next 2 years. <br /> (#3 Permanent Closures x $90) Aim,00 <br /> r- <br /> Total Number of Tanks Total Fee Due /D.00 <br /> 17 A <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet q�7 <br /> with your check. <br /> EXAMPLE -.Annual Fee for Facility with 4 Tanks <br /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil) <br /> Ia. Existing Facility b 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 i Tom, _ zig i o� <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 /> i <br /> 2-86 UGT 21 <br />