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FEE WORKSHEET PER EACH FACILITY ' �- <br /> FACILITY alV�T � <br /> DBA ADDRESS <br /> MAILING' ADORES , ` 931 �rnMo� S TV��oCb�. Cla : gS3 $0 <br /> 1. Operating Permit Application/Annual `tnspection fee',-, O�p <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks R Additional Tanks x $50) � <br /> 2. 'State Surcharge (per tank) (Due with PermitApplicatione <br /> on renewal or amendment of operation permit and temporary closure) <br /> (i56 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. 35 <br /> (/_Temporary closures x $80) (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 /> (fes Permanent Closures x $90) ¢ �� <br /> 5. Plan Check Fee $30. <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 & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 0 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> *Both closures will be conditioned. Contact a Health District Representative <br /> 2-N6 <br />