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VWORKSHIO' PER EACii FACILITY <br /> F AC I L f TY 0 <br /> 08A <br /> MAILING ADDRESS <br /> 1. Operating Permit Application/Annual inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Yanks (M- 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 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 $84) (See above #3 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 /> (f Permanent Closures x $90) <br /> 5. Plan Check Fee $30. <br /> Total Number of Tanks Total Fee Duey <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check . <br /> f'pYME'NT <br /> RECEIVED <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks AUG 27 1987 <br /> .E WONMENT <br /> ( 1 regular, 1 unleaded. 1 supreme, 1 waste oil) At MEgLTy <br /> Ia. Existing Facility & 1st Tank $150 PERMIT/SER E <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total dumber of Tanks 4 Total Fee Due $524 <br /> *Both closures will be conditioned. Contact a_ Health District Representative.sentative. <br />