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., . ✓. �� HUUKtJJ --..iv.>ui l.Ua u �' ��� oc.� /L0, / fioi <br /> nooREss X0 ' [3 x J.2cf >� PAYMr- <br /> RF-CF-IVE'DD <br /> Operating Permit Application/Annual Inspection Fee 'JUL 12 1983 <br /> a. First Tank at Facilitv @ $150. <br /> ENVIRONMENTAV <br /> b. Additional Tanks (P Additional Tanks x $50) AlT(SER�Iiy SALTN <br /> 2. - State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> (556 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 /> (N Temporary closures x $30) (See above d3 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 , <br /> (8 ,I-, Permanent,Closures x $90) '_oo <br /> 5. Plan Check Fee $30. 0 a fZ <br /> Total Number of Tanks Total Fee Due t9.Dr� <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 /> ( l regular, l unleaded. l supreme. 1 waste oil ) <br /> Ia. Existing Facility & 1st Tank $ISO <br /> b. 3 Additional Tanks x $50 ISO <br /> 2. State Surcharge;-4-Tanks x-$56 224 <br /> Total- Number of Tanks 4 Total Fee Due 5524 <br /> "Bath closures will be conditioned. Contact a Heald) District Representative.- <br /> 2-80 <br /> e resentative.2-80 <br /> ryn,ms.,gw. Sa..YMR•+�a a w�.n(E,� ,yip +r.,,- �a..,4,...:,..... " v"'+,. '.R: <br />