Laserfiche WebLink
FEE 110RKSHEET PER EACH FACILITY <br /> FACILITY <br /> DBA � omri� ADDRESS / ;7.,7 <br /> MAILING ADDRESS /;7A172 e�F <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (0 Additional Tanks x $50) <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> (5.56 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 /> (/_ Temporary closures x $80) (See above 13 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 S90) AY�E 60 <br /> p iv <br /> S. Plan Check Fee $30. REG <br /> SES <br /> MESS A�NEP�Z� � ^, <br /> Total Number of Tanks N�1R0N 1315 & �l Fee Due fL <br /> 4E� <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 MO <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 $524 <br /> 'Doth closures will be conditioned. Contact a Health District Representative. <br /> 2-"( <br /> UCS al <br />