Laserfiche WebLink
FEE ,WORKSHEET <br /> ) S <br /> DBA a way <br /> �c13tin, i;a, 8626 <br /> ADDRESS <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> _2—StatPSuccharae (pec tank) - Due with Permit ApPliratinn, <br /> on renewal or amendment of operation permit) <br /> ($56x Total # 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 /> (#_ Temporary closures x $80) <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 within next 2 years. <br /> (# Permanent Closures x $90) <br /> Total Number of Tanks Total Fee Due <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 & 1st Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 22 �. <br /> Total Number of Tanks 4_ Total Fee Due <br /> JAN 2 2 <br /> ENVIROUEvTAL HEALTH <br /> *Both closures will be conditioned. Contact a Health District Represerftp{ i1Yl',ISERVICES <br /> 12/85 <br />