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PUBLIC: HEF`,i SERYIC:ES, SAN- IOAQUIN COUNTY � <br /> 445 N. ;a-n Jo_aquin Street (NOT A MAILING ADDRE S) <br /> P,0. Box 21001 <br /> Stockton, CA 95201 <br /> +:209) 460-3427 �I <br /> Jogi Khanna, M.D. , Health Officer �}j <br /> SIMPSAO �1 <br /> WILLIAM RELF J.H. SIMPSON COMPANY. <br /> A025 C+_ORONADO AVENUE 4025 CORONADO AVENUE <br /> TOCKTON, , CA 9.5204 STOC:KTON, , CA 55204 <br /> 0111111"3 Statement Foo, 199.E Permit, Underground Tank Facility . <br /> Statefeent Cate January 10, 1592 <br /> Payment Due Date; February 10, 1992 <br /> Container fee 000 1 170.00O3,— <br /> TOTAL FEES DUE $170.00 <br /> NOTES: <br /> Notify Public Health Services, D. <br /> Sar. Joaquin County of any <br /> corrections or changes <br /> necessary. Your permit will <br /> be mailed upon receipt of <br /> payment and approval of <br /> facility . � S1'M �� � <br /> iiewi n payliieint along wiv one <br /> copy of this statement to: <br /> h'1iBLIC HEALTH 'SERVICES <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH PERMIT/SERVICES p p $ T E <br /> P.O. BOX 2009 <br /> '�-KTON, CA 952'01 JAN 3 <br /> Penalties will be added -after IMPISBt�I � 0 <br /> due date as shown; <br /> 30 days - 100% of Base Fee <br /> PAYMENT <br /> RECEIVED <br /> FEB 0 4 1992 <br /> $ANJOAQUIN COUNTY <br /> PUBLIC HEALTI i SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br />