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a 40 <br /> FEE WORK•SHLET PER, EACH FACILITY <br /> F Al i L I T Y <br /> pgq � . ADDRESS &X14 <br /> MAILING ADDRESS <br /> ns <br /> 1. Operating Permit Application/Annual inspection Fee rr <br /> a. First Tank at Facility @ $150. e �- <br /> b. Additional Tanks (N Additional Tanks x $50) I <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 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 /> (t 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 /> (/ 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 /> withour check, <br /> y 6d' l <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (1 regular, 1 unleaded, l 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 -„G 0 • <br />