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SEET �. ^. <br /> .fEE WORK k PER EA{'.1i FACtl111•#�;}`:;;z . .�., . �.: . ; -. .'��t��'' ha.��" ' . _ •-a�. <br /> FACILITY <br /> DBA _ .ADDRE5S <br /> WOO <br /> WA1L.tHG lID4R65°� """' ff-_Q <br /> �`` _ ,.f•- •-.;' , .:. . s7.'kfi.,. . . <br /> r.' <br /> .JEL <br /> 1. Operating Perms t''Appl ication/Annual Inspection t=ee <br /> a. First Tank at .Facillity D $150. <br /> b. Additional Tanks (0 Additional Tanks x $50) I Z? <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 ! Tanks) r <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 /> Tea�porary:.closures ;Y$84)`?:{See"ibove #3 to calculate- surcharge) <br /> a• *Permanent Closure (per tank) Underground Storage Tank in which <br /> -,_storage has ceased 'and where the owner/operator has no intent 1 ' <br /> of re-using tank; <br /> (0 - Permanent Closures x $90) <br /> 5. plan Check Fee $30. <br /> OG <br /> Q 310 <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 /> (1 regular. l unleaded. 1 supreme. 1 waste oil ) <br /> Ia. Existing Facility 6 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 />