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FEE WORk.° PER EACH FACILIIT <br /> � ioodyeer Sg V1C6 StON, 1#8W FACILITY <br /> 945—y�, <br /> DBA ,:—F�9�inhsad ADDRESS <br /> ,�� D� <br /> MAILING ADDRESS stwMaN 6ldorn 852L <br /> I. New Facility or Addition <br /> a. First Tank $180. <br /> 3.. <br /> b. Additional Tanks (# Add-"ional Tanks x $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 Applica'Gion, <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 x Total # � Tanks) �, 4 <br /> 4. *Temporary Closure (per tank) Underqround 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. *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 within next 2 years. <br /> (# Permanent Closures x $90) <br /> Total Number of Tanks Total Fee Due d <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check. <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Facility & 1st Tank $1 <br /> b. 3 Additional Tanks x $50 1 _ <br /> 2. State Surcharge, 4 Tanks x $56 2; 4 MAR 2 6 1986 <br /> Total Number of Tanks -4 Total Fee Due VS4VIROMENTAL HEALTH <br /> F ERMIT/SERVICES <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 2-86 <br /> 4k <br />