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.r" SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Avenue, P O Box 2009 <br /> Stockton, CA 95201 <br /> (209)466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> Airport Way Lube Center AIRPO44 <br /> . 442 N. Airport Way AIRPORT WAY LUBE CENTER <br /> . Stockton,CA 95205 442 N. AIRPORT WAY <br /> STOCKTON, CA 95205 <br /> Billing statement for 1986 & 1987 Underground Tank Facility . <br /> Statement Date-: December 8, 1987 Date Due _December 30 1987 <br /> 196 1987 - <br /> Facility $100 Facility $100 <br /> Tank a *Status Tank # *Status <br /> 50 1 A g 50 <br /> --- PAYMENT <br /> — --- _ ---- RECEIVED <br /> - - - - DEC ]7 1987 <br /> State surcharges @ $56 per tank x $ 56.00 p4,41R RNAAIT�S RVICES HEALTH <br /> Subtotal of permit fees 1986 $ 150.00 <br /> Subtotal of permit fees 1987 $ 150.00 <br /> Tarnl, r'r;l•:S uUl•,-: $_356.00 <br /> •A - Active —— <br /> TC - Temporarr'V Cloauro <br /> PC - Permanent C1osurf, <br /> Notify the San .Joaquin Local 11calth Ui :<trict of any crorrectionr; or chant,,.~ <br /> HeLurn payment alont, wt t.h 0114. copy of this statement to : <br /> San Joaquin Local Health District <br /> Environmental Health Permit/Services <br /> P 0 Box 2009 , Stockton , CA 95201 <br />