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PUBLIC F�ALTH SERVICES, SAN JOAQUIN-COUNTY <br /> 445 N. San Joaquin Street (NOT A MAILING ADDRESS) <br /> P.O. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 468-3427 <br /> Jogi Khanna, M.D., Health Officer <br /> TAKAH13 <br /> RON TAKAHASHI SHELL RON TAKAHASHI SHELL <br /> 1313 E. CHARTER WAY 1313 E. CHARTER WAY <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> Billing Statement For 1991 Permit, Underground Tank Facility. <br /> Statement Date : January 7, 1991 <br /> Payment Due Date: February 7, 1991 <br /> - 68.00 <br /> Container Number: 0001 170.00 <br /> 0002 170.00 I'o <br /> 0003 170.00 11-v <br /> Surcharge 168.00 <br /> 91 CI FEES DUE 610.00 <br /> 100% PENALTY 442.00,,Z <br /> TOTAL FEES DUE 2.00 <br /> NOTES: <br /> Notify Public Health Services, <br /> San Joaquin County of any <br /> corrections or changes <br /> necessary. Your permit will <br /> be mailed upon receipt of <br /> payment and approval of <br /> facility. <br /> Return payment along with one <br /> copy of this statement to: <br /> PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH PERMIT/SERVICES <br /> P.O. BOX 2009 <br /> STOCKTON, CA 95201 <br /> Penalties will be added after <br /> due date as shown: <br /> 30 days - 100% of Base Fee <br />