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FDIC HEALTH SffVIN JOAQUIN MUNTlY <br /> 1501 E. Haze I ton*a , P.O. Boy 2009 <br /> Stockton, to 55201 <br /> f20I 468-3425 <br /> Logi 0t�nna, X1.0., Health Officer <br /> Effi,INSS <br /> CITY OF' STf :TCN C.IT'i CF 5TKW - ENGINE CO #4 <br /> 42S N. EL DORADO <br /> STOCKTON, CA 9S.202' '-TOCKTON, CA, 9,5207 <br /> BilliN. Statement Fr-,T 1'40 Permit, T ink Facility. <br /> Statement Date ; January .', 19�() <br /> PC Y�, 90 <br /> an3ti• <br /> ay lent U;.-e Date: F-i-PURry c�, 1 <br /> Facility Fee. 100,00 <br /> Container Number; 0001 -SO.W, <br /> NOTE'S <br /> Notify Public Health '3ervices, <br /> San 3uaruin C:[,uilty of any <br /> Carr rctions C-F' L11s1iiC= <br /> necessary, Your perKtit will <br /> be nailed Upon receipt of <br /> payi*nt• and approval 4i <br /> facility. <br /> Return payient along with one <br /> copy ('1 i-his atatemailt• IL-0: <br /> RIC. HEAL SERVICES <br /> SAN RtAQUI N WiN T`f <br /> ENVIft1aN@I iAL HEALTH PERMi <br /> P.O. SOX 21005 <br /> STOCKTON, t:A 95201 <br /> Penalties will to add-ed ai t-ar <br /> dw date as shrawil: <br /> 30 days - 100% of pae -FR <br />