Laserfiche WebLink
a t <br /> SDA FAC1 L t TY 1 1 <br /> s aaa��ss <br /> fi MAI LING `60ORE5S.. <br /> {Uperatin r i <br /> l ,11.. F ,9 Permit-AFpl icationJAnnuatrlspecttor� Fee <br /> / r, <br /> Forst Tahk btr Faci'11ty fv f <br /> 1= tivnal Tanks (/ Addiv ianal' Tanks x $50) <br /> 2i, 'State per <br /> Surcharge ( tank --� <br /> ) e:C++ith Permit Application. <br /> an renewal or amendment of operation permit and. tempora closure) <br /> (S56 x Total _ ►'S+ <br /> Tanks) <br /> f3• <br /> *Tempo <br /> rary Closure (per tank) Underground Storage Tank " <br /> tJ in which . <br /> storage has ceased but where the owner/operator proposes to <br /> re-use tank within 2 years. <br /> Temporary closures x $DO) (See above .l3 t calculate <br /> *permanent Closure searcha <br /> (p tank) Underground Storage Tank in which ` � ► <br /> ' storage has ceased and where the owner/operator has no Intent <br /> of re-using tank , Y <br /> �� E; a S• <br /> {� Permanent Closures x $90) <br /> 1 111 Pl an Check Fee $30 "� <br /> fi <br /> Total Number of Tanks <br /> Total Fee Due <br /> e V. <br /> EdMake all fees payable to San Jo On Local_ Health -District. Enclose this worksheet. <br /> it your check, <br /> CP <br /> EXAMPLE - <br /> Annual Fee for Facility with 4 Tanks <br /> ( 1 regular, i unleaded, 1 supreme, 1 waste oil ) <br /> . 1 � �' ,r i <br /> a. Existing Facility b 1st Tank \; <br /> I $150 �N <br /> b. 3 Additional Tanks x $50 <br /> F €�f 150 <br /> 2. State Surcharge, 4 Tanks $ <br />!, f� �-- x 56 224 <br /> Total Number of Tanks 4 Total Fee Due <br /> -- S524 <br /> iI <br /> I Vh <br /> '4 °L— h-c1°sUre;will be conditioned. Contact a Health District Representative. l <br /> V <br /> f <br /> �I �l <br />