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F(E WORKSKEITER EACH FACILITY <br /> } •" FACILITY 45 E . Harding , Stockton <br /> OBA Chevron U . S . A . Inc . ADDRESS <br /> MAILING ADDRESS c/o Oil Equipment Service , P .O . Box 950 , San Andreas , <br /> CA <br /> 1. Operating Permit Application/Annual inspection ree PAYMENT <br /> a. First Tank at Facility N $150. RECEIVED <br /> b. Additional Tanks (I Additional Tanks x $50) JAN 7 1989 <br /> 2. State Surcharge (per tank) (Due with Permit Application, ENVIRONMENTAL HEALT4 <br /> on renewal or amendment of operation permit and temporary closurviRMIT/SERVICES <br /> (f56 x Total I 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 /> (I_ Temporary closures x $80) (See above 13 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 /> (i 4 Permanent Closures x $90) $360 . 00 <br /> 5. Plan Check Fee $30. <br /> r <br /> Total Number of Tanks Total Fee Due $360. 00 <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check. <br /> r e,, c; <br /> �?•4o.w <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks G � iIbah <br /> 0 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> Is. Existing Facility b 1st Tank MO <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 />