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FEE NORkt <br /> K•SET PER EACH FACILITO uN Vt6tc-TE� Q�'I `Z4 Q r <br /> OBA �I � ec{ S5mcccj ti lA1Tz{ �(J UY _ADDRESSY <br /> V <br /> �� Il� • DL�VG IlyC �1�LKT B)J <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. �6-6 <br /> b. Additional Tanks (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 /> ($56 x Total Nom_ Tanks) <br /> 3. *Temporary Closure (per tank) Underground Storage Tank in which <br /> storage has ceased but where the owner/operator proposes to 'xb <br /> re-use tank within 2 years. 19810 �i1cYJ— <br /> (/_ Temporary closures x $80) (See above /3 to. calculate surcharge) i� 7 <br /> 4. "Permanent Closure (per tank) Underground Storage Tank in which <br /> storage has ceased and where the gwner/operator has no intent <br /> of re-using tank, <br /> (#__L Permanent Closures x $90) � <br /> 5. Plan Check Fee $30, <br /> dp <br /> Total Number of Tanks Total Fee Due l� <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check. <br /> PAYMENT <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks RECEIVED <br /> ( I regular, 1 unleaded, 1 supreme, 1 waste oil ) AUG 2o 1988 <br /> la. Existing Facility & 1st Tank S15PNVIRONMENTALMEALTH <br /> b. 3 Additional Tanks x $50 150 PERMIT/SERVICES <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 / <br /> POP <br /> *Both closures will be conditioned. Contact a Health District Representative. o' <br /> 2-:tG <br />