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�r <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.O. , Health Officer <br /> STATE MILITARY DEPARTMENTSTOCC80 <br /> <br /> <br /> <br /> , CA 95206 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: JUNE 1, 1987 <br /> Due: 1111 Y 1 11987 <br /> Facility $ 100.00 <br /> Container p *Status <br /> I PC $ 90.00 <br /> 2 A— $ 90-0 <br /> 3 -A— 8 90_0n <br /> - PC 1--2-0---00 <br /> State surcharges @ $56 per tank x <br /> Subtotal of permit fees: $ 380.00 <br /> Additional Billings or Credits <br /> Debit Balance Forward 1986 <br /> (additional tank & sure arge) $ 106.00 <br /> TOTAL FEES DUE: $486.00 <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 /> 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 /> A - Active P. 0. Box 2009, Stockton, CA 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />