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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 466-6781 <br /> J091 Khanna, M.O. , Health Officer <br /> FRED A. <br /> <br /> 4290 CHEROKEE ROAD <br /> STOCKTON, CA 95205 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: MAY 8, 1987 <br /> Due: JUNE 8, 1987 <br /> Facility S 100.00 <br /> Container N Status <br /> A S 50.00 <br /> 5 <br /> State surcharges @ $56 per tank x <br /> Subtotal of permit fees: S 150.00 <br /> Additional Billings or Credits <br /> Additional 1986 fee S 70.00 <br /> TOTAL FEES DUE : S 92n-on <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> past due date as shown: of any corrections or changes necessary. <br /> Permit will be mailed upon receipt of payment <br /> and approval of facility. <br /> 30 days - 100X of Base Fee Return payment along with one copy of this <br /> statement to: <br /> San Joaquin Local Health District <br /> Environmental Health Permit/Services <br /> A - Active <br /> P. 0. (Sox 2009, Stockton, CA 95201 <br /> TC - Temporary Closure <br /> �'( - Pern.nnent Clo,un, <br />