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FEE wORKS4tEET PER EACH FACILITY • • <br /> FACILITY <br /> AODRESS <br /> DBA T�Fi c�lCh JLC �iQlllA/��i C/ c <br /> MAILING ADDRESS y <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150.- 4AtZeOP-Ib 5—� <br /> b. Additional Tanks (l�_ 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 /> (t56 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 $80) (See above 03 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 /> l � <br /> Total Number of Tanks Total Fee Due Ip <br /> Make all fees payable to San Joa uin Local Health District. Enclose this worksheet <br /> with your check. <br /> A <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks RFCYMF <br /> 1 waste oil ) <br /> ( 1 regular, I unleaded, 1 supreme, O Q <br /> la. Existing Facility b 1st Tank $150 N /R /, <br /> 150 PFR �MFj� ` " � <br /> b. 3 Additional Tanks x S50 224 MiT�sF�/cSFq`T�/ <br /> 2. State Surcharge, 4 Tanks x E56 <br /> Total Number of Tanks 4 Total Fee Due $524 (�?✓ <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 2 -26 <br />