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FEE WORKSHLLT PER EACH FACILITY <br /> FACILITY <br /> 'DBA 1Qa-� ADDRESS /COQ AL, J7jGV <br /> MAILING ADDRESSI�GJ�' <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (q 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 H 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 $80) (See above q3 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 /> (N_ Permanent Closures x $90) <br /> 5. Plan Check Fee $30. — <br /> Total Number of Tanks Total Fee Due IO(o <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check. <br /> T <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks REG V Eo <br /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil ) P 1 5'o <br /> lb. 3a. xAdditgional1Tankslity &xI$50Tank $15�gV1 NMjIAsiNIL STH <br /> 2. State Surcharge, 4 Tanks x $56 2224 PERM <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 /> •r <br />