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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Avenue, P 0 Box 2009 <br /> Stockton , CA 95201 <br /> (209)466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> CITY OF TRACY CORRA01 <br /> <br /> CORRAL HOLLOW RD. & I-580 <br /> TRACY, CA 95376 <br /> Billing statement for 1986 & 1987 PERMIT Underground Tank Facility . <br /> Statement Date: MAY 19, 1987 Date Due MAY 30, 1987 <br /> 1986 1987 <br /> Facility $100 Facility $100 <br /> Tank # *Status Tank # *Status <br /> _I A S 50 1 A S 50 <br /> State surcharges @ $56 per tank x 1 = $ 56.00 <br /> Subtotal of permit fees 1986 $ 150.00 <br /> Subtotal of permit fees 1987 $ 150.00 <br /> TOTAL FEES DUE: $ 356.00 <br /> *A - Active <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br /> Notify the San .loaquin Local Health District of any corrections or changes <br /> nece!;:cary . <br /> Return payment along with ono copy of this statement to : <br /> San .loaquin Local health District <br /> Environemntal health Permit/Services <br /> P 0 Box 2009 , Stockton , CA 95201 <br />