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'Ail JOAOUIN LOCAL IIEALTII DISTRICT <br /> 1601 E . IlAzeIton Ave. , P. 0. BOX 2009 <br /> Stockton, Ca 95201 <br /> (209) 466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> OHAIR11 <br /> P. E . <br /> <br /> STOCKTON , CA 95206 <br /> Billing statement for _1987 Permit Underground Tank Facility. <br /> Statement Date : May 1 . 1987 Due_ June 1 _ 1987 <br /> Facility $100 <br /> Container r "Status Container 0 `Status <br /> 1 A S50 S <br /> 3 A 3TJ— — — <br /> 3 A 50 — <br /> 4 A �— — — <br /> State surcharges @ $56 per tank x $ <br /> Subtotal of permit fees : $300 <br /> Additional Billings or creditstoy 7 <br /> ea-Ldnc�duP from 1986 $_�_ <br /> —'-- --- —— --- TOTAL FEES DUE : $337 no <br /> ptnalties rill be added Notify the San Joaquin Local Health District PAYMENT <br /> Past due date as shorn of any corrections or changes necessary. <br /> Pemi[ will be "fled upon receipt of payment RECEIVED <br /> and approval of facility. <br /> JO dayt - 1001 of Batt fee ReturnJUN J 1981 <br /> payment along with one copy of this <br /> statement to <br /> San Joaquin Local Health District ENVIRONMENTAL fnvironmental Health PerilRONMENTAL HEALTH <br /> ,t/Servicer ROOMSERVICES <br /> A active P. 0 9oc <br /> F10. 1009. Stston, (A 9S?01 <br /> tC IrTpo vary Clutu,,• <br /> PC - Prrmanent Clot„rr <br />