Laserfiche WebLink
FEE WORKSHEET <br /> DBA L�N`O G 7& t <br /> ADDRESS ? <br /> I. Operaliing .Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st 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) Underground Storage Tank in which <br /> storage has ceased but where the owner/operator proposes to <br /> re-use tank within 2 years. <br /> (# aJ Temporary closures x $80) G <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 /> to <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 and the completed application. , <br /> EXAMPLE - Annual Fee for Facility with 4 Tanksr, <br /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Facility & 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 <br /> FE8 2 6 E9 <br /> *Both closures will be conditioned. Contact a Health District R4qff.4�NTAL HEALGES TH <br /> 12/85 <br />