Laserfiche WebLink
SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Avenue , P O Box 2009 <br /> Stockton , CA 95201 <br /> (209)466-6781 <br /> J091 Khanna, M.D. , Health Officer <br /> . <br /> <br /> <br /> 1240 E. PINE STREET <br /> LODI , CA 95240 <br /> Billing statement for 1986 .- 1987 <br /> Underground Tank Facility . <br /> Statement Date: AUGUST 25 1g87 <br /> Date Due SEPTEMBER 25 1987 <br /> 1986 1987 <br /> Facility _$lpp pp Facility $100.00 <br /> Tank # *Status Tank X *Status <br /> —1— A S 50.00 1_ A $ <br /> 50.00 PAYMENT <br /> RECEIVED <br /> SEP 191 .9 1987 <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES U X <br /> State surcharges @ $56 per tank x 1 = $ 56.00 j �f II <br /> (� <br /> Subtotal of permit fees 1986 <br /> $ 150.00 <br /> Subtotal of permit fees 1987 <br /> $ 150.00 <br /> TOTAL FEES DUE: $ 356.00 <br /> •A - Active <br /> TC - 'I,empor;u-�, Closure <br /> PC - Permanent Closure <br /> Notify the San Joaquin Local Ilealth D] stt'1 <' t of any corrections Or changes <br /> necessary . <br /> Return payment along with on , copy of this statement to : <br /> San Joaquin Local Ilealth Di:;trict <br /> Environemntal Health Permit/Services <br /> P 0 Box 2009 , Stockton , CA 95201 <br />