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SAN iGAitUIN LOCAL HEALTH DI'3TRICT ® � <br /> 1501 E. Hazelton Ave. , F.O. Box 2Du9 p 1969 <br /> Storkton, CA 95201 )A�) 1 <br /> 2097 453-3425 <br /> Jogi Khanna, M.D. , Health Officer ENVPERMNMI'NTASERI—LTH <br /> LAIDL31 <br /> LAIDLAW TRANSIT LAIDLAW TRANSIT <br /> <br /> STOCKTON, CA 95205 <br /> i <br /> Bi ate u nt. For 1939 Permit., Underground Tank Facility. <br /> atemen,t Date January 1, 1939 <br /> Payment Due Date: February 1 , 1989, <br /> Facility Fee: 100.00 <br /> Container Number: 0001 50.00 <br /> 0002 50.00 <br /> TOTAL FEES DUE $200.00 <br /> • <br /> NOTES; <br /> Notify the Sar. Jof a Loca <br /> Health District of an <br /> CUrrec tl Gils Changes <br /> necessary . Y_ •ermit it <br /> be mailed upon re of <br /> payment and approval a � t( �. <br /> facility. <br /> Return payfient along with one <br /> copy of this statement tG; <br /> :_,AN JOAQUIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH PERMIT/SERVIC:ES U <br /> P.O. BOY, 21009 <br /> STOCKTON, CA 9-5201 <br /> Penalties be added after <br /> due date ass shown: <br /> 3U days - 100% of Base Fe' ' �/� <br />