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PUBLIC HEALTH SERVi' -SAN J("UIN CfRMTY <br /> 1601 E. Hazelton., P.O. Box 200'3 <br /> Stockton. CA 95201 <br /> (209) 465-3425 <br /> Jogi Khanna, M.G., Health Officer <br /> GEORGIC <br /> GEORGE'S SERVICE GEONE'S SERV j <br /> 1600 W. DUM FERRY RD. Im <br /> TRACY, CA 35376 CY, CA 95376 <br /> Billing Statement For 19% Permit, Underground Tank Facility. <br /> Statement Gate ; January 2, 1990 <br /> Payment Due Gate; February 2, 1390 <br /> Facility Fee: 100.00 <br /> Container Number, C*01 50.00 <br /> 0002 50.00 <br /> 0003 50.00 <br /> 0004 50.00 <br /> TOTAL FEES DUE 4300.00 <br /> Notify Public Health Service:, <br /> San Joaquin County of any <br /> corrections or changes <br /> necessary. Your permit will <br /> be mailed upon receipt of <br /> payment and approval of <br /> facility. <br /> Return Payment along with one <br /> copy of this statement to; <br /> PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN GCOXTY <br /> ENVIRNTAL HEALTH PERMIT/SERVICES <br /> P.O. BOX 2005 <br /> STWON. CA 95201 <br /> Penalties will to added after <br /> due date as shown: <br /> 30 days - 100% of Base Fee <br />