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�._..! is ; LTH 4ERVIQES,�SM JOAQUIN {-OVNTY- <br /> 445 aan a�uin StTt NOT A MAILING ADDkji / T <br /> P.O! x 1009 <br /> I Stockton, CA 45201 <br /> C (209) 46e-3427 <br /> Jogi Khanna, j <br /> M.D . Health Officer, I <br /> I I <br /> I SIMP?40 I <br /> WILLIAM RELF .17H. SIMPSON COMPANY <br /> 4025 C:ORONADO AVENUE 4025 C:ORONADO AVENUE <br /> STOCK FON, CA 45204 STOCKTON, , CA 95204 <br /> Billing Statement. For 1991 Permit, Underground Tank Facility. <br /> j Statement Date January 7, 1491 ; <br /> Container fee 0001 170.00 <br /> State surcharge 0001 0-00 <br /> TOTAL FEES DUE $215.00 <br /> I <br /> I <br /> I <br /> NOTES: qF yM <br /> I Notify Public Health Services, S ✓ V N)' <br /> San Joaquin tounty of any F,Y�pUgly g 4 `�1ycF/ �Q <br /> corrections it will changes <br /> ermit. R�hMFTF�T/N�O99/ j <br /> necessary. Your <br /> paymentbe maileandpapprovalon pofvf q( hE(� �c" <br /> I <br /> facility. <br /> Return payment along with one I <br /> Icopy of this statement to: <br /> NBC <br /> T'C HEALTH SERVICE.: <br /> f SAV JUIN COUA:TY <br /> f ENVIRONMENTAL HEALTH PERMIT/SERVIC:ES <br /> P.O. BOX, 2009 <br /> STOCKTON, CA 95101 <br /> Penalties will to added after ; <br /> due date as shown: <br /> 30 days - 100% of Base Fee <br /> I <br /> I , I <br /> I I <br /> I <br /> I I <br /> I I <br />