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� <br /> PUBSERVTC �A <br /> E�, SAN JOUIN COUN <br /> ' 446 N. Sanin Street (NOT A MAILING ) <br /> ' - P.O. BOX 2,0019 <br /> Stockton, CA 95201 <br /> (209) 468-3427 <br /> Jogi Khanna, M.D. , Health Off icer <br /> FRANK14 <br /> FRANK GUINTA, JR. FRANK'S EXXON #4 <br /> P 0. BOX 67 148,00 S, <br /> BANTA, CA 953(214 MANTECA, CA 95336 <br /> Billinv9 �tafeNent For 1,991 Permit, UnuderqrrtWnd Tank Facility. <br /> Statement Date January 7, 19,31 <br /> Payment Due Date: February 11 , 1991 <br /> State surcharge <br /> Container fee <br /> State surcharge <br /> Container fee fke'0�- <br /> State 5WrChar-e fw)f)3-- <br /> Container fee (1004 1-17101.00 <br /> 000S \70.00 <br /> 0006 170.00 <br /> NOTES: --------- <br />� TOTAL FEES DUE $1 , 188 00 <br />� Notify Public Health Services, ========= <br />� San Joaquin County of any /� "-�k-~ oc <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 /> PU�LIC HEALTH SERVIICES ~ <br /> SAN JDA)U%N COUNTY ' �7 <br /> ENVlR[|NMENTAL HEALTH PER��T/SERVlCES ; -,~ � ~-- ^^~^�- �~ <br /> P.O. BOX 2003 <br /> STI OCKT0N' CA 95201 <br /> penalties will be added after <br /> due date as shown: <br /> � <br /> 30 days - 100% of Base Fee ��»~ <br /> � �� <br /> ~7/� <br /> x_ <br /> �� / <br /> ~- <br /> / �J C <br /> L �� '-^ <br />