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FACILITY <br /> RBA ADDRESS vC <br /> ` IMAILING ADDRESS 51A <br /> 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 # 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 /> (N Temporary closures x $80) (See above N3 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 . [' ,�--ff—gff <br /> ( # Permanent Closures x $90) 3 00 <br /> S. Plan Check Fee $30. t�r� r� Cc -( �G� �- � �� Z v <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 /> FXAMPLF - Annual Fee for Facility with 4 Tanks <br /> ( I reqular, I unleaded , 1 supreme, 1 waste {ail ) <br /> I . FxIStinq Facility $ Is Tank, <br /> Ir. 3 Additional T,inks x 550 150 <br /> 1. Stat(, surcharge ,-4 Tanks x $56 124 <br /> Total Numher of Tanks 4 Total Fr'e Due S`374 <br /> 'Both closures will be conditioned. Contact a Health District. Representative__ <br /> Z-.;r. <br />