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SAN J[�iQUIN LOCAL HEALTH DISTRICT <br /> 1E.O1 E. Hazelton Ave. , P.O. Box 2009 <br /> \ 3tocl::ton CA 95201 <br /> l (21x3) 468-3425 <br /> Mogi Khanna, M.D. , Health Officer <br /> BJJ4075 <br /> B J CO. , INC. &JJ CO. ,. INC. <br /> <br /> TRACY, CA <br /> Billing Statement For 1988 Fermi t, Undeif�grclu nd Tank Fac i l i t.y . <br /> Statement Date January i5, 19:38 <br /> E'4Me t ') <br /> WeDnf•e_i- F'etrlaarY 15, <br /> Previous Balance ISO.00 <br /> Facility Fee: 100.00 <br /> a Container Number; 0001 50.00 <br /> ---------- <br /> TOTAL FEES DUE $300.00 <br /> NOTES; 4. <br /> r , <br /> Notify the San Joaquin Local <br /> Health District of any <br /> corrections or changes y / <br /> necessary . Your permit- will dt <br /> be mailed upon receipt of <br /> payment and approval of ' <br /> facility . <br /> Return payment altnY3 with one <br /> - - -"copy of this staterrrent-t._,... <br /> ELAN JOAQUIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH PERMITISER'VICES <br /> P.C. BOX '2009 A'y e, �T <br /> '=TOC:KTON. CA '35 01 IP Cvt <br /> Penalties will be added after �� � }9aa <br /> clue date as shown: <br /> TAL H�TM <br /> 30 days - 100% of Base FeeENVIRONMEN <br /> �ERMIT�SERV1 ���(P <br />