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��� PER EACH FACILITY • C^A ®E k�15 <br /> FACILITY � L <br /> DBAfrCl. �P»^ C�V C[ f �f UY ADDRESS 5 �f /�YII NKA <br /> MAILING ADDRESS f 0 Bx � n 3 11J <br /> I Operating Permit Application/Annual Inspection Fee l b <br /> a. First Tank at Facility @ SI50. J <br /> b. Additional Tanks (I 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) 8 <br /> ($56 x Total I Tanks) 5 U 7 <br /> 3. *Temporary Closure (per tank) Underground Storage Tank in which <br /> storage has ceased but where the owner/operator proposes todt S� <br /> re-use tank within 2 years. 87 897 <br /> (I_ Temporary closures x $80) (See above I3 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 P P G IV EO C?o <br /> (I_ Permanent Closures x $90) Rg <br /> 5. Plan Check Fee $30. <br /> �Mj15� v SES <br /> Total Number of Tanks ��Otal Fee Due <br /> A <br /> 300 <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet 9 pd ID.j7-, <br /> with your check. /Q/31 <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (1 regular, I unleaded, 1 supreme, 1 waste oil ) <br /> Ia. Existing Facility 8 1st Tank $150 <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 /> EH 23 032 2/86 <br /> 0 • <br />