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FEE WO °SHEET PER EACH FACILITY <br /> DOA h ADDRESSYCA' <br /> MAILING ADDRESS <br /> 1. Operating Permit Aplicati /Annual Inspection Fee / <br /> . first Tank-at Facility P $150. <br /> b. Additional Tanks 0 Additional Tanks x $50} <br /> 2. Mate Surcharge (per tank) with Permit Application, <br /> on renewal or amendment of operation Permit and. temporary closure) . <br /> ( x Total f Tanks) <br /> 3. *Temporary Close (per tank) Underground Storage Tank in which <br /> storage has ceased but where theowner/operator proposes to <br /> ,re-use tank within 2 years. <br /> (f Temporary closures x $80) (See above #3 to 'calculate surcharge) <br /> 4. *Permanent Close (per tank) Underground Storage Tank in which <br /> storage has ceased and where the erloperator has no intent <br /> of re-using tank <br /> (f Permanent Closures x $90) t <br /> 5. Plan Check Fee $30. t <br /> i� <br /> PERA <br /> tTI5ER41C <br /> ES <br /> Total Number f Tanks Total Fee Ove <br /> Make all fees payable to San Joaquin Local Health District, Enclose this workshe6t <br /> with your check. <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (1 regular• l unleaded, l supreme, i waste oil) <br /> Ia. Existing Facility & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 I50 <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 oistrict Representative. <br /> 2-1#6 <br />