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tEt WU*-$t4LEI pllt.- FACILITY <br /> t* FACItiCT;Y <br /> oe3� !y <br /> i .r ADO •< ` 7 ' �'`�' <br /> MAILING AOORES- , <br /> 1. Operating Permit Appllcatiod Annual Inspects -tea <br /> a. First Tank at FaCiIipt, <br /> LISA u� <br /> b. <br /> Additional Tanks . (N Additional <br /> r, <br /> 2. 'State_Surchar e (per tank) (Oue withPni � 'fcation, a, F <br /> on renewal or amendment of operation permit and. temporary closure) <br /> ($56 x Total .N Tanks). <br /> x <br /> {. <br />;.3• 'Temporary Closure (per tank). Undergrbund;Storage'R 'ank< in :which. <br /> storage has ceased but where the.owner/operator proposes to <br /> reuse tank within 2 years. <br /> (/ Temporary-closures x_.:80)* ee above- -calculate surcharge) <br /> _. .. . <br /> a• *Permanent,Closure (per tank),.y.bndlerground, 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) 9a <br /> S. Plan Check Fee $30. } <br /> Total Number of Tanks Total Fee Due <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check, <br /> { <br /> cef !3 G /E/,PR'rN C44 /dr1/p ------ <br /> _�._.. <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks Sal ��� 3 <br /> 0 regular, 1 unleaded, l supreme. 1 waste oil ) <br /> Ia. Existing Facility b 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total Number of Tanks 4of T al Fee Due 524 <br /> — S <br /> CX <br /> � <br /> *Both closures will be conditioned. Contatt a Health District Representative. <br /> 2-116 <br />