Laserfiche WebLink
FEE WORKSHEET <br /> DBA (girf�W'R/D/tI Svc/ / lP/SJR <br /> ADDRESS / S/ �� ,/ , NORTff, oCKrA) 95aOS <br /> 1. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and 1st Tank @ $150. $ <br /> b. Additional Tanks (# --�; Additional Tanks x $50) O <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit) / <br /> ($56 x Total # �' Tanks) -2, <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) <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 within next 2 years. <br /> (# Permanent Closures <br /> /xx $90) <br /> Total Number of Tanks 7 Total Fee Due <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check and the completed application. <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> (1 regular, 1 unleaded, 1 supreme, 1 waste oil ) <br /> la. Existing Facility & 1st Tank $150 �/ "`'\\��j„➢ <br /> b. 3 Additional Tanks x $50 150 Y FEB 2 81986 <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> ENVIROMENTAL HEALTH <br /> Total Number of Tanks 4 Total Fee Due $524 FERMIT/SERVICES <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 12/85 <br />