Laserfiche WebLink
FEE WORKSHEET <br /> DBA TIKI LAGuj`4 Rr-5013T P r�jjj;: ! <br /> 12988 Wyes cDonafd Road <br /> Slockton, CA, 95206 <br /> ADDRESS (207) 941,4975 <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and Ist Tank @ $150. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit) <br /> ($56 x Total # `r Tanks) <br /> 3. *Temporary Closure (per tank) UnderniTound Storage Tank M 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 /> pl� --- -" <br /> Total dumber of Tanks r Tot ue <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 <br /> b. 3 Additional Tanks x 550 <br /> 2. State Surcharge, 4 Tanks x $56 <br /> Total Number of Tanks 4 Total Fee Due $524 MAR 4 1986 <br /> ENVIROtd+'ENTAL HEALTH <br /> FERIW/SERVICES <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 12/85 <br />