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Tokay� high School <br /> FEE WORKSHEET PER EACH FACILIT. ' 111'1• *� t ' ztinry Blvd., <br /> FACILITY Vii, CA', 'i-I <br /> Todi Unified School- District ADbRESS Li <br /> Mi 1LING ADDRESS 815 West Lodkeford Street '7odi C� <br /> 1 . New Facility or Addition <br /> a . First Tank $180. <br /> b. Additional Tanks ( H � Additional :,Tanks, x $50) , <br /> 2 . Operating Permit. Application/Annual Inspection Fee <br /> a. Existing Facility and lst 'Tank @, '$150:, <br /> b. Additional Tanks (NL Additional Tanks z $50) " <br /> State Surcharge (per tank) I',(•Dye with 'Permit' Application, <br /> on renewal or amendment off operation permitand temporary closure). <br /> ($56 x Total if Tanks) <br /> e,, *Teim;;or.,ry Closure (per tank; Underground Storage Ta-�' i'n' whic.h <br /> storage has ceased but where the owner/operat'or, proposes to <br /> re-use tank within 2 years.' <br /> 4 <br /> (F_ Temporary closures x, $80) (See above 3 to' col-cul ate 15,yrdharge) <br /> 5 *Permanent Closure (per tank) Und'erg ound Storage Tank to which,' , <br /> storage has ceased and where the owner/operator tias no I',ntent <br /> of r�-using tank 'within next' 2 years. <br /> (d Permanent Closures x, $9,0) 90• <br /> r ' <br /> Total Number of Tanks 1 ITotal Fee 'Due 1 90. <br /> h1,l,e all fees payable to San Joaquin Local- Health District. <br /> Enclose this worksheet <br /> With your check. <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> ----- <br /> ( 1 regular, I unleaded, 1 supre:r,e, 1 waste oil ) <br /> la. Existing Facility & 1'st Tank ' 1 $150, <br /> It. 3 Additional Tanks X $50; 150 <br /> 2. State Surcharge, 4 Ta6ks x ' $56 . 1 224 <br /> I . <br /> Total Number of' Tanks 4 Total, Fee Due $524 <br /> l i <br /> 'i.oth closures will be conditioned. Contact a healthIp S trict Re Presentative; <br /> Z-S6 <br />