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Ir-. <br /> v' PUBLIC HEALTH SERVICES, SAN JOAQUIN COUNTY <br /> 1501 E. Hazelton Ave.,'F.O_ Box 2009 <br /> I Stockton, CA 35201 <br /> (2(Y3) 458-3425 <br /> Jogi Khanna, M.O., Health Officer PAYMENT <br /> RECEIVED <br /> STOCKUti .14 N s o 19,00 <br /> ' <br /> STOCKTON GOLF & COUNTRY CLUB STOCKTION GOLF & COUN'iRY CLIk: SAN IOAgUIn C( <br /> RROtgm Sin„fir,, <br /> P. .O. BOX 336N. COUNTRY CLUB BLVD. ENVIRONA4EN”" <br /> TALrtk�;_;,,�;,... rd <br /> STOCKTON, CA 95201 STOCKTON, CA 952`04 <br /> Billing Statement For 1990 Permit, Underground Tank Facility. <br /> Statement ©ate : January 2, 1990 <br /> Payment Due Date; February 2, 19% <br /> Faidlity Fee: _ ---100-00 <br /> Container Number; 0001 50.0O <br /> (002 50.00 <br /> tPJU3 50.00 <br /> TOTAL FEES DUE $250.00 <br /> NOTES: <br /> Notify Public Health Services, <br /> San SWquin 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. <br /> Return payment along with one <br /> IUBLIC HEALTH SERVICES <br /> FAN JOA0UIN COUNTY <br /> ENVIRONMENTAL HEALTH PERM c.T!'SERVICES <br /> P.O. BOX 2001 <br /> STOCKTON, CA 9520t <br /> Penalties will be added atter <br /> due date as shown; <br /> -2s) days - 100% of Base Fee <br /> V <br />