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FEE WORKSHEET PER EACH FACILITY• qN f-: to 1-40 <br /> DBA ,fNVY 6,12,0 5611)1A�Pd ADDRESSY 1 (9 <br /> MAILING ADDRESS j �ipjYy`�jj� CA <br /> I. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b, Additional Tanks (b Additional Tanks x $50) <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 BTanks) <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 /> (B_ Temporary closures x $80) (See above d3 to calculate surcharge) <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 /> (N__ — Permanent Closures x $90) -! d <br /> 5. Plan Check Fee $30. <br /> )Cie, <br /> Total Number of Tanks Total Fee Due <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet �;I pejo <br /> with your check, 01 <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> ( 1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Facility b 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 Total Fee Due $524 <br /> `Both closures will be conditioned. Contact a Health District Representative. <br /> 7-HG <br /> /)(1-7 _7 I <br />