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FEE WORKSIILET PER EACH FACILITY FACILIT ` 1a <br /> DBA / c ADDRESS <br /> Y <br /> r\ <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual inspection Fee <br /> a. First Tank at Facilit.v @ $150. <br /> b. Additional Tanks (I 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 N Tanks) <br /> 3. '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 f3 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. 9() <br /> (I1 Permanent Closures x $90) I <br /> S. Plan Check Fee $30. <br /> dy C� <br /> Total Number of Tanks Total Fee Due � <br /> Q� <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, l supreme, 1 waste oil ) <br /> Ia. Existing Facility 6 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 /> 'Both closures will be conditioned. Contact a Health District Representative. <br /> 2 -86 <br />