Laserfiche WebLink
' Lr` u••�n r „t 11111' • <br /> OBA <br /> FACILITY <br /> �d of /iC <br /> �� ADDRESS pc CJ S L <br /> MAILING ADDRESS <br /> L Operating Permit App, cation/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. _ <br /> b. Additional Tanks (I 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 N Tanks) <br /> 3• *Temporary Closure <br /> (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 /> (N_ Temporary closures x $80) (See above /3 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 /> (a Permanent Closures x S90) PA Y AIJ N r <br /> 5. Plan Check Fee 530. C <br /> FNL l RONAI cN r <br /> Total Number of Tanks PE- Atlr `rqL H`�LTT <br /> "t�1S�tal�Fee Due <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your chick -- -- ----- ------ <br /> EX-AMPLE - Annual Fee for Facility with Tank; <br /> ( 1 regular, I unleaded , I upr-t,fxw ' I waste nil <br /> la , fx1stury facility R I, I i,tnT <br /> b, i Additiruial T,fnk., <br /> 7. State 4 Tank, 55h <br /> lotal Number of Tanks 4 Total Fee Dur <br /> S` ln <br /> * loth closures will be conditioned, Contact a Health District Representative. <br /> 2-AG <br /> UCS .� l � • <br />