Laserfiche WebLink
'tt wURK511LL1 PER EACH FACILE <br /> ' DBA �f V JAFACILITY I, DRESS <br /> MAILING ADDRESS <br /> t I- Operating Permit Application/Annual Inspection Fee <br /> 4 <br /> a. First Tank at Facility @ 8150. <br /> b. Additional Tanks (N I Additional Tanks x $50) Imo_ 5v <br /> 2, State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> (856 x Total N L' Tanks) 112 <br /> 3. 'Temporary Closure (per tank) Under �— <br /> ground Storage Tank in which <br /> storage has ceased but where the owner/operator proposes to <br /> re-use tank within 2 years. <br /> (N_ Temporary closures x 880) (See above #3 to calculate surcharge) <br /> 4. t=� <br /> "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 , <br /> (X_ Permanent Closures x 890) <br /> 5. Plan Check Fee $30. <br /> --iffy- <br /> Total Number of Tanks ' <br /> — — Fee Due " <br /> 312 200 X2170 <br /> To')-cd Fie bile c $1`7 I Z <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 /> ( I regular. I unleaded, 1 supreme, I waste oil ) <br /> Id. Existing Facility & 1st Tank <br /> $150 <br /> b. 3 Additional Tanks x $50 <br /> I50 <br /> 2. State Surcharge , 4 Tanks x $56 <br /> — 224 PAyNIENT <br /> Total Number of Tanks 4RECEIVED <br /> Total Fee Due $524 <br /> Fct 1G 1�3 <br /> *Both closures will be conditioned, jNVIPERMIT�SERVICESNTAL LTH <br /> — Contact a Health District Representative. <br /> 2-86 — <br />