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* 46 <br /> FEE WORKSHEET PER EACH FACIL <br /> FACILITY (�p I �ET7"L.E i"1f�fJ Lr°5 tJ E <br /> DBA � / /� UL � U1JIOr1 1� ADDRESS <br /> MAILING ADDRESS L_op1 Cmc• �2�0 <br /> 1. New Facility or Addition <br /> a. First Tank $180. <br /> u. Additional Tanks (# Additional Tanksx $50) ; <br /> 2. Operating .Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. 160 <br /> I' <br /> b. Additional Tanks (# 'ry 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 # -A 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 /> 5. *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 within next 2 years. <br /> (# Permanent Closures x $90) <br /> x. <br /> Total Number of Tanks Total Fee Du` <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 /> la. Existing Facility & 1st Tank $150 ` q <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 <br />