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A ' <br /> 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 /> e <br /> d <br /> CITY OF STOCKTON •ENGIN55 <br /> 425 N. EL DORADO ST. • ENGINE CO #4-CITY OF STOCKTON <br /> STOCKTON, CA 95202 •5525 PACIFIC AVENUE <br /> -STOCKTON, CA 95207 <br /> Billing statement for 1987 PERMIT , Underground Tank Facility. <br /> Statement Date: APRIL 15, 1987 <br /> Due: MAY 15, 1987 <br /> Facility $ i oo <br /> Container # Status <br /> 1 A $ 50 <br /> 2 A- 50 <br /> State surcharges @ $56 per tank x _ _ $ <br /> Subtotal of permit fess: $ 90n.On <br /> Additional Billings or Credits <br /> TOTAL FEES DUE: $ 200.00 <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> after 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 t <br /> ' statement to: <br /> San Joaquin Local Health Di stri <br /> * Environmental Health Permit/Ser ce�S�AY 2 ��7 <br /> A - Active P. 0. Box 2009, Stockton, CA 95201 <br /> TC - Temporary Closure ENVIROMENTAL HEALTH <br /> PC - Permanent Closure FERMIT/SERVICES <br />