Laserfiche WebLink
FEE WORKSHLET PER EACH FACILI,,. <br /> DBA OaNyu, I AV, I UP FACILITY n <br /> T��v,:a Com'• ADDRESS IIZ�9 W, U/m �d'/KkJ <br /> MAILING ADDRESS <br /> PAYA4ENT <br /> I. Operating Permit Application/Annual Inspection Fee R E C EIV E D <br /> a. First Tank at Facility @ $150. PnQR 1 1 o," <br /> b. Additional Tanks (b Additional Tanks x $50) <br /> 2. State Surcharge (per tank) (Due with Permit Application, ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 x Total M 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 /> (M_ Temporary closures x $80) (See above N3 to calculate surcharge) <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 , <br /> (# I Permanent Closures x $90) 9U� <br /> 5. Plan Check Fee $30. <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 8 1st Tank 5150 <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 5524 <br /> *Both closures will be conditioned. Contact a Health District Re resentative. <br /> 2-8G <br /> 0G-7- <br /> of <br />