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FEE WORK-SHEET <br /> PER EACH FACT# <br /> .J�sA ��K�J. DCIG £Pj AFACILITY <br /> '� . DaRESS � `��• ��. <br /> MAI(ING Ill)DRESS 5 <br /> I- Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facilit.v @ �R`YMFI'�IT <br /> 515]. RECEIVED <br /> b• Additional Tanks # <br /> 2. ( Additional Tanks x $5O) ---- <br /> State Surcharge (per tank =+ <br /> (Due with Permit Application, <br /> TA <br /> on renewal or amendment of operation kNVlRONME <br /> ($56 x Total /� permit and temporary closu IT ERVI ES LTH <br /> Tanks) � f 1C�fS <br /> 3- *Temporary Closure <br /> (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) <br /> 4• *Permanent Closure ) (See above #3 to calculate surcharge) <br /> (per tank) Underground Storage Tank in hich <br /> storage has ceased and where the owner/operator has no inw <br /> tent <br /> of re-using tank , <br /> (# Permanent Closures x $9O) <br /> 5. Plan Check Fee $30, P► � <br /> Total Number of Tanks <br /> Total Fee Due 0O <br /> Make all fees payable to San Joaquin Local Health District. Enclose this work h <br /> with your check s eet <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> ( I regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility $ Ist Tank <br /> $150 <br /> t}. 3 Additional Tanks x $50 <br /> ? 150 <br /> State Surcharge , 4 Tanks x $56 <br /> ---- Z24 <br /> Total Number of Tanks 4 <br /> Total Fee Due $514 <br /> *Hath closures will be conditioned. Contact a Health District Representative. <br />