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Ftt-KO'RK•WLU PER EACH FACILITY <br /> DBA �l�4 c+� )`,� �. ADDRESS <br /> 1 <br /> MAILING ADDRESS <br /> 1, Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $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 I 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 V 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 /> (1--L Permanent Closures x $90) 0 , <br /> 5. Plan Check Fee $30. <br /> Total Number of Tanks Total Fee Due <br /> Make all fees payable to San Joa uin Local Health District. Enclose this worksheet <br /> with your check. <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> 0 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Facility b 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 /> EH 23 032 2/86 <br />