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" . . <br /> FACILITY' <br /> I1oC}RESS `iJ ` GLS <br /> 0 ratfn � Pirm Applicati Annual Inspection flee / <br /> a. 'first ,Tank"ac Fa vi I it;V f $15Q. <br /> t b. Additional 'Tanks Additional Tanks x 50) <br />'. State Surcharge (per tank) (Due with Permit Application, <br />' <br /> on renewal or amendment of operation permit and. temporary closure) <br /> 4 <br /> y.: <br /> ($56 atal N t Tanks) <br /> *T porary, Closure (per tank) Underground' Storage Tank in which <br /> storage has ceased but where he'ownerl perator proposes to <br /> -use tank within 2: years. <br /> Temporary ,closures x $80) (See above #3 to calculate surcharge) <br /> mahept Clasure (per tank) Underground Storage "Tank in which <br /> 4K <br /> ' storage has ceased and whe the owner/operator hasAll <br /> no intent <br /> cl rte-using tank, <br /> 44 Pierfa trent close x 0) <br /> S. Plan Check Fee X30. <br /> Total Number, of Tanks Tptal� Fee Due <br /> Make all fees payable to San Jouin <br /> aqLocal Health District. Enclose this worksheet <br /> with your check. <br /> EXAMPLE - Annual Fee for Facility with ,4 Tanks: <br /> (I regular, 1 unleaded, l supreme, 1 waste oil ) <br /> la. Existing ,Taci1,ity & ist Tank $l5Q <br /> b. 3 Additional Tanks x 5Q 150 <br /> 2State Surcharge,' 4 Tanks x $56' 224 <br /> Total Number of Tanks 4 Total F60"Oue $524 <br /> Closures frill be conditioned 'Goma t a Health nQiitri+ t IR eosela 'J <br /> u <br /> i <br />