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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Avenue, P O Box 2009 <br /> Stockton , CA 95201 <br /> (209)466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> JOSEPH NEWFIELD <br /> P. 0. BOX 516 NEWFI10 <br /> WOODBRIDGE, CA 95258 NEWFIELD <br /> 107 N. SCHOOL ST. <br /> LODI, CA 95240 <br /> Billing statement for 1986 & 1987 Underground Tank Facility . <br /> Statement Date: MAY 20, 1987 Date Due JUNE 20, 1987 <br /> 1986 1987 <br /> Facility $lnn Facility $100 <br /> Tank N *Status Tank X *Status <br /> 1 A b 50 1 A b 50 <br /> 2 A -2- A 50 <br /> 3 A— — 1 A 50 <br /> 4_ -50-- 4 A 50 <br /> 5 '� <br /> State surcharges $56 per tank xq = $ 280.00 <br /> Subtotal of permit fees 1986 $ 350.00 <br /> Subtotal of permit fees 1987 $ 350.00 <br /> TOTAL. FEES DUE: $ 980.00 <br /> *A - Active f�_/-S>7 1G� <br /> TC - Temporary Closure o� 5 ao <br /> PC - Permanent Closurr <br /> NoLify Lhe 6M, ,Joaquin Local Ilealth D1SLrlcL of anycoe'rectio or hanger <br /> ncce:;:cary . <br /> IleLurn paynu'nL along wi th onc• Copy of this; statement to : <br /> San .Joaquin Local Health DisLrict <br /> Environemntal Ilealth Permit/Services <br /> P O Box 2009 , Stockton , CA 95201 <br />