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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P.O. B:x 2009 <br /> S t-ac k:ton, CA 95201 <br /> (209) 468-3425 <br /> Jogi Khanna, M.D. , Health Officer <br /> SCO T TS 1 <br /> <br /> <br /> TRACY, CA 9076 <br /> Billing Statement For 1988 rermit, Underground Tank Facility. <br /> Statement Date : .January 15, 1988 <br /> Payment Due Datei February iS, 1988 <br /> Facility Fee; 100.00 <br /> Container Number: 0001 50.00 <br /> 0002 50.00 <br /> o003 60.00 <br /> TOTAL FEE'S DUE $20.00 <br /> NOTES: <br /> Notify the 'San Joaquin Local <br /> Health District of any <br /> corrections or changes <br /> necessary . Your permit will <br /> be mailed upon receipt- of <br /> payment and appy caval `of <br /> facility . <br /> Return payment along with one <br /> copy-of this statement to: <br /> AN JOF'QUIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH PERMIT/SERVICES <br /> P.O. BOX 2009 <br /> STOC:KTON, CA 9520t <br /> Penalties will be added after <br /> due date as shown: <br /> 30 days - 100% of Base Fee <br /> 1F a _ <br />