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::AN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P.1-1. Box 2009 <br /> c:t.ockton, CA 96201 <br /> (209) 458-3425 <br /> Jogi Khanna, M,D. , Health Officer <br /> CHEVRIO <br /> JAMES <br /> <br /> TRACY, CA 95476 <br /> I <br /> i <br /> Billing Statement. For 1989 Permit, Underground lank: Facility . <br /> Statement. Date January 1 , 1989 <br /> Payment Due Date: etruary 1 , 19r,9 <br /> Facility Fee: 100.00 <br /> Container Number. 0001 so.00 <br /> 000 ' SO.00 <br /> 000:3 SQ.00 <br /> 0004 60.00 <br /> TOTAL FEES DUE $300.00 <br /> NOTES <br /> Notify the 'San Joaquin Local <br /> Health District of any <br /> corrections or changes <br /> necessary. Your germit will <br /> be trailed upon receipt. of <br /> payment. and approval of <br /> facility . <br /> Return payment along with One <br /> copy of this sj.atement to: <br /> -AN JOAQUIN LOCAL HEALTH DISTRICT <br /> EN'd1RONMENTAL HEALTH PL=RMITISER'JICE3 <br /> F.D. BOX 2009 <br /> STOCKTSUN, CA 9S2011 <br /> penalties will be added after <br /> due date as shown; <br /> I <br /> 30 days - 100% of rase Fee <br />