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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 466-6181 <br /> Jogi Khanna, M.D. , Health Officer <br /> GENERAL MILLS INC. 'GENER20 <br /> P. 0. BOX 3002 GENERAL MILLS <br /> 2000 W. TURNER RD. <br /> LQDI , CA 95241 •LODI , CA 95240 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: March 15, 1987 <br /> Due: A ril 15, 1987 <br /> Facility <br /> $ 100.00 <br /> Container # *Status <br /> 2 A 50.00 <br /> SOD <br /> 4 - O--QD <br /> 6 � PAYMENT <br /> RECEIVED <br /> State surcharges @ $56 per tank x <br /> 4 <br /> Subtotal of permit fees: ENVIRONMENTAL HEALTH <br /> $ 400.00 PERMIT/SERVICES <br /> Additional Billings or Credits <br /> $ <br /> TOTAL FEES DUE: $ 400.00 <br /> Penalties will be added <br /> 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 /> 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 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 />