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08A . V a r. <br />MAILINi ADDRESS <br />.. <br />2. <br />3. <br />4. <br />S. <br />0 <br />ADDRESS <br />J_ \_T Al <br />Operating Permit Application/Annual. Inspection fee <br />a. First -Tank at Facility @ $150. <br />b. Additional Tanks (1' Additional Tanks 4..$50) <br />'State Surcharqe (per tank) (Due with Pemit Application, <br />on renewal or amendment of operation_ permit and.'temorary closure) <br />($56 x Total N Tanks) <br />*Temporary Closure (per tank) Underground Storage Tank -in which <br />s toraged has. ceased but where the owner/operator proposes to <br />re -use tank within 2 -years. <br />(/Temporary closures x SBD) (See above -/3 to calculate surcharge) <br />Vermanent 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 />(/ Permanent Closures x:$90) <br />Plan Check Fee $30. <br />Total Number of Tanks Total Fee Due <br />Make all fees payable to San Joaquin Local Health District. <br />with your check. <br />Enclose this worksheet <br />EXAMPLE - Annual Fee for Facility with 4 Tanks <br />(l.regular. 1 unleaded. 1 supreme. 1 waste oil) <br />Ia. -Existing Facility 6 1st Tank <br />b. 3 Additional Tanks x $50 <br />2. <br />State Surcharge, 4 Tanks x <br />$56 <br />Total <br />Number of Tanks 4 <br />*66th closures will <br />be_cond'itioned.. Contact -a <br />Heal <br />$150 <br />150 <br />224 <br />Total Fee Due $524 <br />