Laserfiche WebLink
unnjiuLi rtn tNut rAt,ltW fACILITY _ S � n/T S o G1J <br /> ADDRESS <br /> 40 <br /> S F <br /> IN6 AODRESS <br /> Operating Permit Application/Annual inspection Fee <br /> a, First Tank at Facility @ <br /> b, Additional Tanks SAdditional Tanks x $50) <br /> State Surcharge (per tank) (Due <br /> with Permit Application• <br /> closure) <br /> on renewal or amendment of operation permit and temporary <br /> (S56 x Total A <br /> Tanks) <br /> Closure (per tank) Underground Storage lank in whit <br /> *Temporary rator proposes to <br /> storage has ceased but where the owner/ope <br /> re-use tank within 2 years. <br /> (I_ Temporary closures x $80) (See above 13 to7nnkcinawhichreharge <br /> 4. *permanent Closure (per tank) Underground Storage <br /> storage has ceased and where the owner/operato'r has no intent <br /> of re-using tank . <br /> (# , Permanent Closures x $90) <br /> 5, Plan Check Fee $30. <br /> Total Fee Due <br /> Total Number of Tanks 3 <br /> Make all fees payable to San Joa uin 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 /> 5150 <br /> Ia. Existing Facility b 1st Tank 150 <br /> b. 3 Additional Tanks x $50 224 <br /> 2. State Surcharge. 4 Tanks x S56 <br /> Total Number of Tanks 4 <br /> Total Fee Due $524 <br /> Contact a Health District <br /> *Both closures will be conditioned. Repre_ s t{Ve- <br /> 2 .1.0 <br /> .: i <br />