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a <br /> FEE WORKSHEET PER EACH FACILITY <br /> FACILITY <br /> " A ADDRESS 2-0 <br /> firo <br /> MAILING ADDRESS <br /> CIE <br /> 1. Operating Permit Application/Annual Inspection' Fee <br /> a <br /> a. First 'Tank at Facility P $150. <br /> . Additional Tanks (0 Additional Tanks x $50) <br /> Z. ; Spate Surcharge (per tank) (Due with Permit Applications <br /> on renewal or amendment of operation permit and- temporary closure); <br /> ($56 x Total #' Tanks) <br /> 3. *Temporary Closure (per tank) Underground Stora Tank in which <br /> storage has ceased but where the owner/operator proposes to <br /> re-use tank within 2 years. <br /> (#_ Temporary closures x $80) (See above #3 to calculate surcharge) <br /> 4. *Permanent Closure (per tank) Underground Storage Tank in which <br /> storage has ceased and where the (?wner/operator has no intent <br /> of re-using tank. <br /> (#__L Permanent Closures x $ 0) ------ <br /> S. Plan Check Fee $30. -- -- <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 /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (I regular. Iiunleaded, I supreme. I waste oil) <br /> la. Existing' Facility & ist 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 Total Fee Oue $524 <br /> *Goth closures will be conditioned. Contact a Health District Representative. <br /> 2-,�1, <br />