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u <br /> SAN JOAt,U1N LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. ; P.D. Ern: 200.3 <br /> Stockton, CA 95101 <br /> (209) 460342S <br /> jogi Khanna, M.D. , Health Officer <br /> TAKAHI3 <br /> RON TAK:AHASHI SHELL RON TAKAHASHI SHELL <br /> 1313 E. CHARTER WAY 1313 E. CHARTER WAY <br /> STOCKTON, CA 9520:= STOCKTON, CA 96205 <br /> i i 1 ing St.at.e'nent. For 19'`89 Permit, Underground Tank: Facility . <br /> Statement. Date : January 1 , 1989 <br /> Payment Due Dater February 1 , 199 <br /> Facility Fee: 100.00 <br /> Container Number ; 0001 .SO.00 <br /> 0002 SO.00 <br /> 0003 50.00 <br /> TOTAL FEES DUE 31501.00 <br /> )TES: <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 app'ro'val of <br /> facility . <br /> Return payment along with one, <br /> copy of this statement to: <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH PERMITISER'VICES <br /> P.O. BOX 2009 <br /> STOCKTON, CA 95201 <br /> Penalties will be added atter <br /> due date as shown:; <br /> 30 Clays - 100; of Ease Fee <br />