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' FEE'S, RKS1iLET PER EACH FACIL* <br />FACILITY <br />OBA,•CHEVORN USA, INC. ADDRESS 2905 W. BENJAMIN HOLT STOCKTON, CA <br />MAILING ADDRESS 2 ANNABEL LANE, SUITE 200, SAN RAMON, CA 94583 <br />I. <br />Operating Permit Application/Annual Inspection Fee <br />a. First Tank at Facility @ $150. 150 <br />b. Additional Tanks (#_Z_ Additional Tanks x $50) 100 <br />2• State Surcharge (per tank) (Due with Permit Application, <br />on renewal or amendment of operation permit and temporary closure) <br />3. <br />M <br />($56 x Total M 3 Tanks) C� 1�, i'l 168 <br />*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 />(N - Temporary closures x $80) (See above N3 to calculate surcharge) <br />*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 />(# 4 Permanent Closures x $90) <br />5. Plan Check Fee $30. <br />RECEIVED' <br />Total Number of Tanks REMOVE 3, ADD 3 ENVIRONMENTAL <br />Fee Due <br />NMENTAL HE LTH <br />PERMIT/SERVICES <br />Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br />with your check, <br />EXAMPLE - Annual Fee for Facility with 4 Tanks <br />(1 regular, 1 unleaded, 1 supreme, 1 waste oil) <br />la. Existing Facility & 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 4 <br />Total Fee Due $524 <br />*Both closures will be conditioned. Contact a Health District Representative. <br />2-86 <br />610T <br />N/A <br />30 <br />