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rAc1LIIY0 <br /> & q ADDRESS �� '� PA '/' — 1--7-roGkr�.� <br /> MAs]LtNG ADf)RLss , f . 773 <br /> I . Operating Permit Application/Annual inspection Fee <br /> a. First Tank at Facility @ $1.50. <br /> b. Additional Tanks (# 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 # Tanks) <br /> *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 /> *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 /> Plan Check Fee $30. 11 <br /> Total Number of Tanks Tota; Fe4 Due 30">3 <br /> 5T4T <br /> ke all fees payable to San Joaquin Local^Health District. vF-00itto worksheet <br /> th your check . R E <br /> N��ENTAL �IEALTN <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks �N �E�v',IYJ` tiCL-S <br /> ( 1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existinq Facility R ist 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 /> th closures will be conditioned. Contact a Health District Representative. <br /> 6 <br /> I <br />