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FEE 146RKSHEET PER EACH FACiLI• • <br /> 06A -PO-e�" `�\ Rpu ADDRESSY 1/2 Y (i) LAWe Sp�erToI <br /> MAILIN6 ADDRESS LI� LJ, W <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (I 0� 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 /> (156 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 /> (0..'O`Temporary closures x $80) (See above 13 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 /> 2 laermanent Closures x $94) ( S U <br /> 5. Plan Check Fee $30. <br /> M <br /> Total Number of Tanks Total Fee Due <br /> Make all fees payable to San Joaquin Local Health District. Enclose this w kyMV:{v T <br /> with your check . RECEIVEfl <br /> JUL 13 l�oc <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks 1NVIRONMENTAL HEALTH <br /> VICE <br /> ( 1 regular.' I unleaded, 1 supreme. I waste oil ) <br /> PERMIT <br /> Ia. Existing Facility b 1st Tank 5150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. - State Surcharge, 4 Tanks x S56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> *Both closures will be conditioned. Contact a Health District Representative_ <br /> 2-11.6 <br />