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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> WOODC68 <br /> CLAUDE C. WOOD CO. CLAUDE C. WOOD COMPANY <br /> P. 0. BOX 599 686 E. LOCKEFORD <br /> LODI , CA 93240 LODI , CA 95240 <br /> Billing statement for _1487 Permit Underground Tank Facility. <br /> Statement Date: APRIL 15, 1987 <br /> Due: MAY 15, 1987 <br /> Facility $ 100.00 <br /> Container # "Status <br /> A 50.00 <br /> 2 A LOO <br /> State surcharges @ $56 per tank x = �_ <br /> Subtotal of permit fees: $ 200.00 <br /> Additional Billings or Credits <br /> Balance Forward 1986 - Credit - $ 106.00 <br /> TOTAL FEES DUE: $ 94.00 <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> past due date as shown: of any corrections or changes necessary. <br /> Permit will be mailed upon receipt of payment <br /> and approval of facility. <br /> 30 days - 100% of Base fee Return payment along with one copy of this <br /> statement to: <br /> San Joaquin Local Health District <br /> Environmental Health Permit/Services <br /> A - Active P. 0. Box 2009, Stockton, CA 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />