Laserfiche WebLink
4 0 4 <br /> FSE WORKSHELT PER FACH®CILI1 <br /> FACILITY <br /> DBA � , _ ADDRESS 4-70 slain St . , PJanteeD <br /> MAILING ADDRESS <br /> 3 3 <br /> 1. New Facility or Addition <br /> a. First Tank $180. <br /> b. Additional Tanks (# Additional Tanks x $50) <br /> 2. Operating Permit Application/Annual Inspection Fee <br /> a. Existing Facility and lst Tank @ $150. <br /> b. Additional Tanks (# 2 Additional Tanks x $50) 11)9 . <br /> 3. State Surcharqe (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 x Total # 3 Tanks) 1G <br /> 4. *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 #3 to calculate surcharge) <br /> 5. *Permanent Closure (per tank) Underground Storage Tank in which <br /> storage has ceased and where the owner/operator has no intent <br /> of re-usinq tank within next 2 vars,. <br /> (# Permanent Closures x $90) <br /> Total Number of Tanks 3 Total Fee Due $41F. 0-1) <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 /> la. Existing Facility & lst Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> *Both closures will be conditioned. Contact a Health District Representative. <br /> 2-36 <br />