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s <br /> FEL WPkKSrt(kl PER EACH FACILITY !p e7tJ�J <br /> FACILITY <br /> OSA Ps 4' © ADDRESS` <br /> 6MAILING ADDRESS <br /> I. Operating Permit Application/Annual Inspection Feee <br /> a. First Tank at Facility @ $150. <br /> - b. Additional Tanks (N Additional Tanks, xs50) '� ' <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 N 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 /> EN Temporary closures x $80) (See' above N3 to calculate uroh rge ; <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 /> U Permanent Closures x -$90) ( 90 <br /> S. Plan Check Fee $30. j ` <br /> a <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 /> curt t 3�G Na1 r►j r �� M/P <br /> ~ <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> ( 1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility & 1st Tank $150 <br /> bo 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 /> V <br /> Doth closures will be 'conditioned. Contact a Health District Re2resentative. <br /> 2-116 <br /> T <br />