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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Avenue , P 0 Box 2009 <br /> Stockton , CA 95201 <br /> (209)466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> . FAA Airway Facilities Sector • TRACY <br /> . 21615 Hesperian Blvd. , Suite A Tracy IFST <br /> Hayward, CA 94541 Schulte Rd. , E of Patterson Pass Rd. <br /> Tracy, CA 95376 <br /> Billing statement for 1986 & 1987 Permit Underground Tank Facility . <br /> Statement Date: July 21, 1987 Date Due August 21 1987 <br /> 1986 10000 1987 <br /> . <br /> Facility Facility <br /> Tank # *Status Tank # *Status <br /> _A_ $_59 oo 1 -PL- $_90_00 <br /> State surcharges @ $56 per tank x 1 = $ 56.00 <br /> Subtotal of permit fees 1986 $ 150.00 <br /> Subtotal of permit fees 1987 $ 90.00 <br /> TOTAL FEES DUE: $ 296.00 <br /> 'A - Active <br /> TC - Temporary ,---- <br /> PC - Permanent Closure <br /> Notify the San Joaquin Local health DistriCt of any correction.,; or changes <br /> necessary . <br /> Return payment ;'long with one copy of this statement to : <br /> San Joaquin Local Health District <br /> Environmental Health Permit/Services <br /> P 0 Box 2009 , Stockton , CA 95201 <br />