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• SAN JOAQUIN LOCAL HEALTH OISTRfCT <br /> 1601 f , H,t to 1 ton Ave. 1'. (). Box 7()Oq <br /> Stockton, CA 95201 <br /> (209) 466-6781 <br /> Jagi Khanna, M.D. , Ifea l th Officer <br /> CORIZl; !'h,1) S'1'11'i'!;MliN'I' <br /> I�NGIN11 <br /> CI'1"f OF -STOCKTON CITY OF STOCKTON <br /> 425 N . ];L DUIZAUO, IZOUh1 312 CITY <br /> COMPANY #L <br /> STOCKTON , CA 95202 110 W . SONOIZA <br /> STOCKTON , CA <br /> 61111ng statement for 1987 Permit <br /> Underground Tank Facility. <br /> Statement Date: JUNE 1 , 1987 <br /> Due: JULY 1. , 1987 <br /> Facility <br /> S 100 <br /> Container 'Status <br /> it <br /> 3—LO . 0 0 <br /> 3 50 . 00 <br /> 4 —.5O . 00 <br /> 50 . <br /> 00 <br /> Subtotal of perrni t fees: <br /> S 300 .00 <br /> Additional Billings or Credits <br /> & SURCHAlZGES 1986_ — <br /> 5 106 . 00 <br /> TOTAL FEES DUE: ~ -- S 4-- ,_C)0 <br /> Penalties will be added �~— <br /> after due date as shown: Notify the San Joaquin Local Health District <br /> of any corrections or changes necessary. <br /> Permit will be mailed upon receipt of payment <br /> 30 days - 100% of Base Fee and approval of facility. <br /> Return payment along with one copy of this <br /> statement to: <br /> San Joaquin Local f#ea 1 th {:t <br /> En v i ro rime n ta I HV�l1t11 Permit; ',t�rvices <br /> nt t � vr t'_ 0. Box 2009, Stockton , <br />