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Ave <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 E. Hazelton Ave., P.O. Bo. 2009 <br />Stockton, CA 95201 <br />(209) 468-3425 <br />Jogi Khanna, M.D., Health Officer <br />RUN POLHEMUS <br /> <br /> <br />POLHE21 <br />RUN POLHEMUS <br />21132-SLICKMG <br />£SCALON. CA 95320 <br />Billing Statement. For 1989 P'ermi't, Underground Tank: Facility. <br />Statement Date . July 1, 1989 <br />Payment Due Date; August 1, 1989 <br />Facility Fee: <br />Container Number, 0001 <br />TOTAL FEES DUE <br />NOTES: <br />Notify the 'San Jpaquin Local <br />Health District 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 />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />ENVIRONMENTAL HEALTH PERMIT/SERVICES <br />P.U. BOY. 2009 <br />STOCKTON, CA 95201 <br />Penalties will be added after <br />due date as shown: <br />30 days - 100% of Base Fee <br />100.00 <br />50.00 <br />X150.00 <br />