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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> U,01 E. ia<e1te-n Ave. , P.O. Box 2009 <br /> Stockton, CA °•`_-tial <br /> l 2u'3) 453-3 i 8 <br /> Jogi Khanna, M.D. , 'ti a:tln Officer <br /> THRIF76 <br /> <br /> <br /> STOCKTON, CA 98£07 <br /> Billing 'Statement. For 19.88 Permit, Undergratilndi Tank Facility. <br /> Statemant Date January 15. 19'38 <br /> Payment Clue Datef February 15;` 19'C�., <br /> Facility Fee: 100.00 <br /> Container Number; 0001 50.00 <br /> 0002 SO.00 <br /> 0003 50,90 <br /> 0004 50.00 <br /> TOTAL FEES DI $300,00 <br /> NOTES: <br /> Notify the San Joaquin Local <br /> Health District of any <br /> corrections or charm-es <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 /> SAN jOAlxliIN LOCAL HEALTH Ci_:"IRICT #, PAYMENT <br /> ENVIRONM£NTAL HEALTH PERMIT/SERVICE'S RECEIVED <br /> P.C. B:1 X 2009 <br /> STOCKTON, CA 95201 FEB 81988 <br /> Penalties will be added after jENVIRONMENTAL HEALTH <br /> due date as shown: pERMITiSERVICES <br /> 30 days.- 100;, of Base Fee i <br /> t <br />