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0 -0 <br /> FEE WORKSHEET PER EACH FACILITY <br /> FACILITY <br /> DBA - ADDRESS <br /> MAILING ADDRESS <br /> 00 <br /> rCo <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. / <br /> b. Additional Tanks (rl Additional Tanks x $50) �./ K5 <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 /> {/ Temporary- closures x $80) (See above #F3 to calculate surcharge) <br /> 4. *Permanent Closure (per tank) Underground Storage .Tank in which <br /> storage has ceased and where the gwner/operator51'D"'1 ?j1'1A dt <br /> of re-using tank_ H11d3H l`d1NMNOMN3 Q�pJ <br /> Permanent Closures x $90) 88611 Z <br /> �� l <br /> 5. Plan Check Fee $30. <br /> Q3AI303a <br /> l.N3WAVC1 <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 `� f <br /> t <br /> ( 1 regular, 1 unleaded, 1 supreme. 1 waste oil ) <br /> 1a. Existing Facility b 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 jS Z. <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total Number of Tanks 4 Total Fee Due 5524 <br /> "Both closures will be conditioned. Contact a health District Representative. <br />