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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 /> Jogi Khanna, M.D. , Health Officer <br /> •UHAUL45 <br /> U-HAUL CO. OF FRESNO •U-HAUL CO. - LODI MOVING CENTER <br /> LODI MOVING CENTER •450 N. CHEROKEE LANE <br /> 450 N. CHEROKEE LANE •LODI , CA 95240 <br /> LODI, CA 95240 <br /> Billing statement for 1987 PERMIT Underground Tank Facility. <br /> Statement Date: APRIL 15, 1987 <br /> Due: MAY 15, 1987 <br /> Facility $ 100 <br /> Container # "Status <br /> 1 g $ sn <br /> _50__ <br /> - � n <br /> PAYMENT <br /> — �— RECEIVED <br /> �— MAY 4 1987 <br /> State surcharges @ $56 per tank x = �_ ENVIRONMENTAL HEALTH <br /> Subtotal of permit fees: $250 PERMITISERV ICES <br /> Additional Billings or Credits <br /> S <br /> TOTAL FEES DUE: $ 250.00 <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 - 100% 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 P. 0. Box 2009, Stockton, CA 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />