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. 1 <br /> 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 /> CgRo•f sl��e •-ht -R�_9-__ _ <br /> . SAN JOAQUIN COUNJY/UTE: C • <br /> <br /> STOCKTON , CA 95206 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: May 8, 1987 <br /> Due: June 8, 1987 <br /> Facility $ 100 <br /> Container # Status <br /> 1 <br /> A $50 <br /> �— PAYMENT <br /> $ — RECEIVED <br /> r _ — $ MAY 2 0 19.b <br /> .ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> Subtotal of permit fees: $ 150 <br /> Additional Billings or Credits <br /> TOTAL FEES DUE: $150. 00 <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> after due date as shown: of any corrections or changes necessary. <br /> Permit will be mailed upon receipt of payment <br /> and approval of facility. <br /> 30 days - 100% of Base Fee Return payment along with one copy of this <br /> statement to: <br /> San Joaquin Local health District <br /> Environmental Health Permit/Services <br /> P. 0. Box 2009, Stockton, CA 95201 <br /> A - Active <br /> TC - Temporary Closure <br /> PI - Permanent Closure <br />