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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. s Health Officer <br /> . J.S.G. TRACKING COMPANY . JSGTRI9 <br /> 19400 N. HIGHWAY 99 . J.S.G. TRUCKING COMPANY <br /> ACAMPO, CA 95220 . . 19400 N. HIGHWAY 99 <br /> ACAMPO, CA 95220 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: JUNE: 25, 1987 <br /> Due: JULY 15, 1987 <br /> Facility 100 <br /> Container M *Status <br /> --1— A 50.00 <br /> --�- A0 <br /> --�— �' 0 <br /> LBO <br /> Subtotal of permit fees: <br /> 5 350.00 <br /> Additional Billings or Credits <br /> TOTAL FEES DUE: S350.00 <br /> Penalties will be added Notify the San Joaquin Local I4ealth District <br /> after due date as shown : of any corrections or changes necessary. <br /> Permit will be mailed upon receipt of payment <br /> 30 days - 100% of Base Fee and approval of facility, <br /> Return payment along with one copy of this <br /> statement to: PAYMENT <br /> San Joaquin Local Health District RECEIVED <br /> Environmental Health Permit/Services <br /> A - Active P. 0. Box 2009, Stockton, t !, `l5?()1 UL 15 1987 <br /> TC - Temporary Clo .irr <br /> P,'rrm,lnoF1 t C l o., .ENVIRONMENTAL HE.,�Tf�-' <br /> PERMIT/SERVICES <br />