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FEE WQRK-SNEET PER EACH FACILITY • • <br /> FACILITY <br /> DBA LST ST I'n Ki 4V,36o j L,—,q ADDRESS 134 S �� <br /> MAILING ADDRESS &TL? C9F ��C ILTDI a� 1 <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ 5150. <br /> b. Additional Tanks (M__L Additional Tanks x $50) 5 SO <br /> 2. State Surcharge (per tank) (Due with Permit Application. <br /> on renewal or amendment of operation permit and temporary closure) I ) 2 <br /> ($56 x Total N 2 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 /3 to calculate surcharge) <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 /> (0_2— Permanent Closures x $90) a� <br /> S. Plan Check Fee $30. <br /> Total Number of Tanks �i Total Fee Due L <br /> Make all fees payable to San Joaquin Local Health District. c ose this woorks ee E13 AyNT <br /> with your check. RECg►VE1D <br /> OCT 11998 <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks ENVIRON MENTAL HEALTH <br /> iTISERVICES <br /> ( 1 regular, 1 unleaded, 1 supreme, 1 waste oil ) PEW32(a <br /> Ia. Existing Facility & Ist Tank $150 (� � , ,�h�,J � �1 <br /> b. 3 Additional Tanks x $50 150 �yC1, A <br /> 2. State Surcharge, 4 Tanks x $56 224 \� <br /> Total Number of Tanks 4 Total Fee Due 5524 <br /> "Both closures will be conditioned. Contact a Health District Representative. <br /> UG-� � <br />