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FEE WORKS"EET PER EACH FACILITY <br /> FACILITY <br /> MAILING ADDRESS <br /> fu"s <br /> . Operating Pemit'Application/Annual Inspection Fee <br /> . First 'Tank at Facility p $150. ..w. <br /> b. Ad ditional Tanks Additional Tanks x $ ) <br /> 2. State Surcharge (per tank) (Due with Permit Application,; <br /> on n al' or amendpient 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 butwhere theowner/operator proposes.to <br /> re-use tank within 2 years. <br /> 0 Temporary closures x $80} (See above #3 to calculate surcharge) <br /> 4. *Pe neat Closure -(Per tank) Underground Storage Tank in which <br /> storage has ceased and where theowner/operator has no intent a <br /> f re-using tank. <br /> U Permanent Closures x D ------- <br /> S. Plan Check Fee $30. --�------ <br /> Total Number of Tanks <br /> Total Fee Due <br /> Make all fees payable to San Joaquin local Health District. Enclose this worksheet <br /> with -your Check. <br /> tV <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks SEP 2,0 1988 <br /> l <br /> (I regular, i unleaded, 1 supreme. 1 waste o� NMW8 ,T/,E§y0ES <br /> T L LTH <br /> la. Existing;Facility a ist Tank <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total Number of Tanks 4Total Fee Due $524 <br /> `Both closures will be conditioned., Contact a Health District R2presentative. <br /> BE 23 032 2/86 <br />