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FEE WORKSHEET PER EACH FACIOY • <br /> DBA J& W pFE LANDING FACILITY <br /> ADDRESS 137 YS lt/ t .1'Nu l GRcvc Ret�U <br /> MAILING ADDRESS )�,p, rox t{17 �HORNTa+1 � Li %S6 PC <br /> I. Operating Permit Application/Annual Inspection Fee PAYMENT <br /> a. First Tank at Facility @ $150. RECEIVED <br /> b. Additional Tanks (N Additional Tanks x $50) MAR 1 j 1989 <br /> 2• State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit ENVIRONMENTAL HEALTH <br /> and temporary closu49MIT/SERVICES <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 /> (M_ Temporary closures x $80) (See above N3 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 , g <br /> (N Permanent Closures x $90) 2�k '16 <br /> 5. Plan Check Fee $30. <br /> Total Number of Tanks — Total Fee Due l�n <br /> f 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 /> Ia. Existing Facility & 1st 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 /> U6T a <br />