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, <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton, CA 96201 <br /> (209) 466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> CITY OF STOCKTON ENGINIICITY OF STOCKTON <br /> 425 NORTH EL DORADO - Room 312 ENGINE COMPANY #2 <br /> STOCKTON, CA 95202 110 14EST SONORA <br /> STOCKTON, CA 95203 <br /> Billing statement for 19$7 Permit Underground Tank Facility. <br /> Statement Date: MAY 1, 1987 <br /> Due: JUNE 1_2_1987 <br /> Facility $ 100.00 <br /> Container M Status <br /> 1 A 50,00 <br /> —2 A 50,00 <br /> ---3— T- <br /> —4 <br /> State surcharges @ $56 per tank x <br /> Subtotal of permit fees: $ 300.00 <br /> Additional Billings or Credits <br /> TOTAL FEES DUE : S300.00 <br /> Penalties will be added Notify the San Joaquin Local Bealth District <br /> past due date as shown: 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 oris <br /> s to temen t to: <br /> Sari Joaquin Local health District <br /> Environmental Health Permit/Services <br /> A - Active P. 0. Box 2009, Stockton, CA 95201 <br /> T(. - Temi)orar-y Closur, <br /> C l ri of r,. <br />