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FEE WOP.K-SHEET PER EACH FACILITY / • <br /> FACILITY � /kL (Ln0knAj <br /> osa �� I �-�i�S �v' �I rJU� aooREss ��31 ii/VVV /J c`t� D <br /> MAILING ADDRESS ec) E'() 9Sao� <br /> N AGI Liz 3h <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ 1150. <br /> b. Additional Tanks (N 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 M 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 /3 to. calculate surcharge) <br /> 4. "Permanent Closure (per tank) Underground Storage Tank in which <br /> storage has ceased and where the 9wner/operator has no intent <br /> of re-using tank , <br /> (#oZ Permanent Closures x $90) <br /> S. Plan Check Fee $30. <br /> Total Number of Tanks <br /> Total Fee Due / �o•.o <br /> 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 ) I <br /> la. Existing Facility 8 lst 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-RG <br /> UCS a1 - � <br />