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P kic *Avi SERVIciJWIN IiIUNTY <br /> 445 N. San Jasmin StreeO�Af A NAILING ADDRESS) <br /> P.U. Bax M. <br /> Stockton, CA 95201 <br /> (209) 40it-3427 <br /> dogi Khanna, M.D., Health Officer <br /> ROTORA <br /> ROTO-RW ER m7TO-ROOTER <br /> P O BOX 5543 AW E. WPENTER <br /> :iOC:KTiV, CA 95205 STOCKTON, CA '35205 <br /> Billirr Statement For 1'?31 Permit., Ur&rjrouro Tar'; Facility. <br /> Statement Date ; April 3, 1Y31 <br /> Payment We Date; May 3, 1931 <br /> ContarrKr fee (KU1 170.0 <br /> State surcharge 061 1%-0 <br /> Cw,tairler fee 002 170.0 <br /> State surcharge W01 S+i.00 ? <br /> i <br /> TOTAL FEES DUE 1452.0 <br /> NOTES% <br /> Notify Putrlic Health Services, <br /> San Joaquin County of any <br />� <br /> corrections. or changes <br /> necessary. Your Permit will <br /> be mailed upon receipt cif <br /> payment and approval of { <br /> facility. J <br /> Return payment atom with one <br /> copy of this statement tv; <br />� <br /> PUBLIC HEALTH :.ERVICf5 <br /> SAN JWIN (Mly <br /> £NVIMIENTAL HEALTH PMIT/SERVICU <br /> P.O. BOX 209 <br /> STOCKTON, CA 95201 <br /> Penaltie5 will l* added after <br /> due date as shown: J <br /> :0 days - 101 cd Base Fee � <br /> 1 <br /> i <br /> ?I <br />