Laserfiche WebLink
FEE WORKSKET PER EACH FACILITY <br /> FACILITY <br /> OBA STr �r��� J- 70 <br /> �r v - ADDRESS ��� f7•�"° ��f� <lfTa93iy� <br /> MAI L I NG ADDRESS_ <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility O $150. <br /> b. Additional Tanks (1 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 /> (556 x Total k Tanks) <br /> 3. *Temporary Closure (per tank) Underground Storage Tank in which <br /> storage has ceased but where the caner/operator proposes to <br /> re-use tank within 2 years. <br /> (! Temporary closures x $80) (See above t3 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 /> U <br /> (! Permanent Closures x $90) <br /> S. Plan Check Fee $30. <br /> Total Number of Tanks <br /> Total Fee Due �C_3 <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check. pladE <br /> A <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> APR 14 1987 <br /> ( 1 regular, 1 unleaded, 1 supreme. 1 waste oil.) 'EI VIROMENTAL HEALTH <br /> 1a. Existing. Facility & 1st Tank <br /> $150 'F ERMITJSERVICES. <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x S56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> `Moth closures will be conditioned. Contact—a liealth District Representative. <br /> 2-""6 <br />