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KKIC HEALTH SERVICES, JOAWIN WY <br /> 1601 E. Hazelton Ave .D. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 458-5425 <br /> Jcgi manna, M.D., Health Officer <br /> ENGIN.55 <br /> CITY OF STOCKTON CITY OF STKN - ENGINE CO #4 <br /> 425 N. EL DORADO 5525 PACIFIC AVENUE <br /> STOCIw'TON, CA 95202 ST(WON, CA 95207 <br /> Billing Statement For 1990 Permit, Underground Tank Facility. <br /> Statement Date , January 2, 199+1 <br /> Payrent Due Date: February 2, 19% <br /> Facility Fee: 100.00 ' <br /> Container Nurber. 0001 50.00 <br /> 002 50.00 :: 5 <br /> C1yll`�7 (��1U1•.` ..}��f�.rV,s <br /> TOTAL FEES DUE $2OO.O0 �f s <br /> �r <br /> •Y <br /> I <br /> NOTES, <br /> Notify Public Health Services, <br /> San o:nrlin runout. of any <br /> corrections or charKes <br /> necessary. Your permit will <br /> be Trailed upon receipt of <br /> payffent and approval of <br /> facility. <br /> Return p•aymant along with one <br /> lopy of this statement. too <br /> PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COOKY <br /> ENVIRCtiMENTAL HEALTH PERMIT/SERVICES <br /> P,0. KIX 2M <br /> ),TODJON, CA 95201 <br /> Per es will to added after <br /> due date as shwn: <br /> _* days - 100x% of Base Fee <br /> 0,0 <br /> Ga <br /> I <br />