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PUBLIC HEALTH SERVICES OPgUIN <br /> SAN JOAQUIN COUNTY = y <br /> <: -Z" .a <br /> N. < <br /> JOGI KHANNA AD.hiP H <br /> HeaIrh OfficerP.. <br /> 041 <br /> P.O. Box 2009 • (1601 East Hazelton Avenue) • Stockton, California 95201 tiF 5a N� <br /> (209) 468-3400 <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 445 N. SAN JOAQUIN (P.O. BOB 2009) <br /> STOCKTON, CA. 95201 <br /> (209) 468-3427 <br /> Guard C. Darrah <br /> 3536 N. Rainer <br /> Stockton, Ca. 95204 <br /> Darra35 <br /> FACILITY LOCATION: 3536 N. Rainer, Stockton. <br /> Billing for 1986 thru 1991 fees for permit to own and/or operate an <br /> Underground Storage Tank Facility. <br /> Statement Date: August 12 , 1991 <br /> Payment Due Date: September 12, 1991 <br /> 1986 1987 1988 1989 1990 1991 <br /> Facility Fees: $100. 00 100. 00 100. 00 100. 00 100. 00 N/A <br /> Container Fees: <br /> Tank 0001 $50.00 50. 00 50. 00 50. 00 50. 00 170. 00 <br /> Tank 0002 N/A <br /> State Surcharge <br /> Fee: Tank 0001 56 . 00 56. 00 <br /> Tank 0002 N/A <br /> TOTAL AMOUNT OF FEES DUE: $ 1, 032 . 00 <br /> If you have any changes <br /> or corrections please <br /> call our office when <br /> statement is received <br /> at (209) 468-3427. <br /> Penalty's will be added <br /> after the due date shown. <br /> 30-days at 100%of base fee. <br /> Please remit one copy of <br /> this statement with <br /> your payment to: <br /> Public Health Services <br /> Environmental Health Division <br /> P.O.Box 2009 <br /> Stockton, CA. 95201 <br /> A Division of San Joaquin County Health Care Services ��' <br />