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FEE WORKSHEET PER EACH FAL <br /> FACILITY"l <br /> DBA ADDRESS + _ <br /> MAILING ADDRESS MANTECA BEAN CO. <br /> P. O Box 1003—?A7 Ile PPn f i31 d <br /> Manteca, Calif. 95336 <br /> 1. New Facility or Addition <br /> a. First Tank $180. <br /> b. Additional Tanks ( P Additional Tanks .x $50) <br /> 2. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> 3. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 x Total N Tanks) <br /> 4. *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 #3 to calculate surcharge) <br /> 9ermanent 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 within next 2 years. <br /> (# 3 Permanent Closures x $90) 00 <br /> Total Number of Tanks Total Fee Due <br /> Dh ty Taw K-rA 7ws a <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, 1 unleaded, 1 supreme. 1 waste oil ) <br /> Ia. Existing Facility b 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 /> 2-86 UGT 21 0 0 <br />