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r <br /> SAN JOAQUiN LOCAL HEALTH 01'8:"iRiC:l <br /> 1601 E. Hazelton Ave. , P.O. Box 2009 <br /> Stockton, CA 35201 <br /> (209) 465-:3425 <br /> jogi Khanna, M.O. , Health Officer <br /> HILLM25 <br /> BENJAMIN HILLMAN BENJAMIN HILLMAN <br /> `: <br /> ;TOCKTON, CA '35206 <br /> Bi I! ing St.ate.rnent. For 1969 Perrki t, Underground Tank Fac i I i ty . <br /> Statement. bate January 1 , 1.329 <br /> Payment. Due Date: February 1 , 19'8.3 <br /> Prev iC.us balarice %12.00 <br /> Fa'-ility Fee; 100.00 <br /> Facility Fee; 1pti.00 <br /> 000 1 50.00 <br /> UOIii <br /> SO.00 <br /> 0302 so.00 <br /> 0002 50.00 <br /> TOTAL FEES DUE <br /> NOTE:;; <br /> Notify the San Joaquin Local <br /> Health District" of any <br /> corrections or chance= <br /> necessary . Your permit will <br /> be mailed upon receipt of <br /> Payment erkd approval of <br /> facility . <br /> Return payrpent alon-9 with one <br /> copy of this statement to; <br /> SAN JOAuU11 LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH PERMITISERVICE: <br /> P.O. BOX 2009 <br /> STOCKTON, CA 95201 <br /> Penalties will be added after <br /> due date as shown: <br /> 0 days - 100% of Bane Fee <br /> � `1d <br /> {209) 4,6->. 34:2''_ <br /> Jo•gi Khanna, M . 1) . , Hent tk, Of f <br /> BENJAMIN HILLMAN I &w, <br /> 3426 S AIRPORT .WAY <br /> STOCKTON, CA 95206 <br /> rrec" t,.,i =t t ri; nt. FINAi... NO ICc <br /> r Ir� <br /> On tri January 15, i'�rc:;3 t.i-.e -Gave ac i 1. i.t.y was. L,i 1 leo; for an Underciround Tay <br /> Facility . !?-kis fee is for you;' required p:.rri,i. n ,_kpG.i-at.e for the period <br /> aa'ruary <br /> boo t , th_•c:errkbe•i 1 , i'}C; ;. <br /> penalties were added to tine '"+ i: 3 ?7i .kiml!, ,;P the past dire arfkOunt for 198"-" <br /> fE?e= c,l-,'iy tis c;fMarch 15, 1988 Tht, arrkount' 'now due- anti payable i5 $912.00. <br /> If jayrriellt. ha=. ,Br3:i .: Y4 . , -,!case disregard this nGkiCr . _;hrjul,d you have <br /> any questi C1y,4- <br /> ;.J �.Yiis'. billi =_;tat.eiiierkt, ple3a°_ict <br /> B cnL.act. this offi e <br /> 1r;i Gl.i' � ng <br /> at. (2(r3) 46; -_421S betweei`t 8;00 A . M . and <br /> N;it•ify the `,mark Jiaaquin Local <br /> Health District. of any cr,rrect.ic:ns <br /> Cir chan=fes nE'Ces5ary . YOuP permilt: <br /> will b•- mailed upon receipt of payment. <br /> and approval of f a(C i 1. i ty . <br /> Tic-t.ur'n payment along with one copy <br /> CA this staterf,ent. t-0 ; <br /> SAN JOAQr_ IN 03CAL Hf=AL'TH pISTRICr <br /> ENVIRCINMENTAL HEAL"CFI pEFP1I'i!:_ERVItt:_: <br /> P . Lt . Bi]X :20f)'3 <br /> STOCK (ON, CA. 9S2,0 I <br />