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.FEE WORKSHEET PER EACH FACILITY* , . <br /> / FACILITY <br /> DBA W ADDRESS <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> �- -,� <br /> a. First Tank at Facility @ 5150. <br /> b. Additional Tanks (I Additional Tanks x $50) <br /> 2. State Surcharge (per tank) (Due with Permit Application, n f' <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 x Total N Tanks) t <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 /> (i Temporary closures x $80) (See above #3 to calculate surcharge) <br /> 4• *Permanent Closure (per tank) Underground Storage Tank in which <br /> storage has teased and where the owner/operator has no intent , <br /> of re-using tank, �O <br /> (0 Permanent Closures x $90) ---- <br /> 5. Plan Check Fee $30. . <br /> Total Number of Tanks r--, 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. 1 unleaded, 1 supreme, 1 waste oil) <br /> Ia. Existing Facility & 1st Tank 5150 <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 /> 2 +O <br />