Laserfiche WebLink
`. smale <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Avenue, P O Box 2009 <br /> Stockton , CA 95201 <br /> (209)466-6781 <br /> Jog1 Khanna, M.D. , Health Officer <br /> ' CALIFORNIA HIGHWAY PATROL CALIF38 <br /> <br /> 385 W.GRANTLINE RD. <br /> TRACY, CA 95376 <br /> Billing statement for 1986 & 1987 Underground Tank Facility . <br /> Statement Date: __ NOVEMBER 3 1987 Date Due NOVEMBER 30, 1987 <br /> 1986 1987 <br /> Facility _ $100 Facility $100 <br /> Tank p *Status Tank q *Status <br /> 1 A S 50 1 A S 50 <br /> State surcharges ® $56 per tank x_]`= $ 56.00 <br /> I <br /> Subtotal of permit fees 14186 $_ 150.00 <br /> Subtotal of permit fees 1987 $ 150.00 <br /> TOTAL Fra•:S DUI.:: $ 356.00 <br /> 'A - Active <br /> -- -- <br /> '1'C - '1'empor:r r) Cl u::ur <br /> Notify the San .l o:ulu in Lvcal Health Ilr ::tt•tet ul any rerr t'eclt <>n <br /> n�','l-:;!i:11.N. . <br /> l(CUlrn payment alone; with ung• copy of this: stateuutnt to: <br /> San Joaquin Local Health District <br /> Environmental Health Permit/Services <br /> P 0 Box 2009, Stockton , CA 95201 <br /> PENALTIES WILL BE ADDED <br /> PAST DUE DATE AS SHOWN: <br /> 30 DAYS - 100% of Base Fee <br />