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0 <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1501 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 455-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> VALLE80 <br /> VALLEY CRETE INC. VALLEY CRETE, INC. <br /> P. 0. BOX 747 802 S. AMERICAN ST. <br /> STOCKTON, CA 95201 STOCKTON, CA 95206 <br /> Billing statement for 1987 PERMIT Underground Tank Facility. <br /> Statement Date: APRIL 15, 19€37 <br /> Due: 87 <br /> Facility $ 100 <br /> Container # *Status <br /> 1 A X50 <br /> PAYMENT <br /> $ RECEIVED <br /> $ MAY 4 1j87 <br /> State surcharges @ $55 per tank x W = ENVIRONMENTAL HEALTH <br /> Subtotal of permit fees: $150 PERMIT/SERVICES <br /> Additional Billings or Credits <br /> TOTAL FEES DUE: $1s-0.00 <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> past*due date as shown:= of any corrections or changes necessary. <br /> Permit will be mailed upon receipt of payment <br /> and. approval of facility. <br /> 30 days - 100 of Base Fee Return payment along with one copy of this <br /> statement to: <br /> San Joaquin Local Health District <br /> * Environmental Health Permit/Services <br /> A - Active P. 0. Box 2009, Stockton, CA 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />