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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> -STOCKTON GOLF & COUNTRY CLUB STOCK06 <br /> P. 0. BOX 336 STOCKTON GOLF & COUNTRY CLUB <br /> STOCKTON, CA 95201 W. COUNTRY CLUB <br /> STOCKTON, CA 95024 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: APRIL 1, 1987 <br /> Due: MAY 1, 1987 <br /> Facility $ 100.00 <br /> Container N *Status <br /> 2 g $ 56.00 <br /> 3 Sn n0 <br /> PAYMENT <br /> State surcharges @' $56 per tank x = RECEIVED <br /> $ - <br /> Subtotal of permit fees: $ 250.00 APR 16 1987 <br /> Additional Billings or Credits ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> TOTAL FEES DUE: $ 250.00 <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> Past due date as shown: of any corrections or changes necessary. <br /> Permit will be mailed upon receipt of payment <br /> 30 days - 100% of Base Fee and approval of facility. <br /> Return payment along with one copy of this <br /> statement to: <br /> San Joaquin Local Health District <br /> ' Environmental Health Permit/Services <br /> A - Active P. 0. Box 2009, Stockton, CA 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />