Laserfiche WebLink
FEE WORKSHLLT PER EACH FACILI _ 1 <br /> p FACILITY <br /> DBA ��/bW1v— [dLaJ� ADDRESS /0/`�� <br /> MAILING ADDRESS 10,/cfrlr <br /> I. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. <br /> b. Additional Tanks (N 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 /> ($56 x Total k 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 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 , J <br /> (#__L Permanent Closures x $90) Qr7 <br /> 0, <br /> 5. Plan Check Fee $30. <br /> Total Number of Tanks Total Fee Due ?40 <br /> 0 <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check , <br /> PAYMENT <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks RECEIVED <br /> ( 1 regular, 1 unleaded, 1 supreme, I waste oil ) NOV 2 :-, 1986 <br /> Ia. Existing Facility & 1st Tank $1 5 iNVIRONMENTAL HEALTH <br /> b. 3 Additional Tanks x $50 150 PERMIT/SERVICES <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total Number of Tanks 4 Total Fee Dui' $524 <br /> `Both closures will be conditioned. Contact a Health District Representative. <br /> 2-'rtG <br />