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SOJOAQUIN LOCAL HEALTH DISTRICT 41 <br /> 1601 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 466-6781 <br /> Jogi Khanna, M.O. , Health Officer <br /> USPOS42 <br /> U.S, POSTAL SERVICE US.POSTAL SERVICE4245 WEST LANE <br /> 4245 WEST LANE <br /> STOCKTON, CA 95204 STOCKTON, CA 95204 <br /> ' <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: MAY 15, 1987 <br /> Due: JUNE 15, 1987 <br /> Facility S 100.00 <br /> Container N Status <br /> 1 A S 50.00 <br /> 2 A S 50-00 <br /> 3 A 50-OD <br /> State surcharges @ S56 per tank x = <br /> Subtotal of permit fees: S ?5n0 <br /> Additional Billings or Credits <br /> S <br /> -TOTAL FEES DUE: 5250.00 <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 /> Sari Joaquin Local licaltal District <br /> Environmental Health Permit/Services <br /> P. 0. Box 2009. Stockton . CA 95201 <br /> A - Active <br /> TC - Temporary Closure <br /> � f - frr•rfblrL•ni CIOSUrr <br />