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1 <br /> Billing Statement <br /> PUBLIC HEALTH SERVICES SAN JOA9VIN C. <br /> DIVISION OF ENVIRONMENTAL 'HEALTH A <br /> PERMIT-SERVICES <br /> :TOC:KTON, CA 95205 S F�1 <br /> 468 3425 �Q <br /> PETE KOOYMAN TRUCKING stiff 9ti O <br /> P.C. Bain 1300 <br /> S FOCKTON,CA 95201 % ti <br /> PETEK1 <br /> Re; URderground Tants: Permit Fees; <br /> Facility Location : 1340 W CHARTER WAY STOCK'TON, CA 95206 <br /> Billing for 1986 through 1989 lees for permit to,operate <br /> Statement Date AUGUST 7, 1381 <br /> Payment. Due Date; 'SEPTEMBER 7, 1999 <br /> } <br /> Facility Fees; 1986 1987 1998 1981 <br /> 100.00 100.00 100.00 100.00 <br /> SCt rtC': SO�OCi SCt,(t0 <br /> Tank 0001 50.00 <br /> a Tank '0002 50.00 Sf).00 50.00 S0.00 <br /> Tank 0003 <br /> Tank 0004 <br /> Tank <br /> Tank is <br /> State Surcharge <br /> Fee: Tank 0001 55.00 <br /> Tank 0002 56.00 <br /> Tank 0003 <br /> Tank 0004 <br /> TOTAL AMOUNT OF FEES DUE: ------------------------------------- <br /> 90.00 <br /> i <br /> 1? _ a _ _ <br /> yUU have any ch„wes W <br /> corrections please call our <br /> office when statement is <br /> received. <br /> Penalty's will be added after <br /> the due date as shown; <br /> 30 - days A 100% of Mase fee <br /> Please remit with payment a copy <br /> of this statement to { <br /> San Joaquin Lr, '. l ealtt, District, !' <br /> Environmental- pith Permit Seivices <br /> 1601E Hazelton he <br />