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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Avenue, P 0 Box 2009 <br /> Stockton , CA 95201 <br /> (209)466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> GOLF LAND <br /> 7850 N. WEST LANE GOLF LAPID <br /> STOCKTON, CA 95210 7850 N. WEST LANE <br /> STOCKTON, CA 95210 <br /> Billing statement for 1986 - 1987 Underground Tank Facility . <br /> Statement Date: JUNE 2, 1987 Date Due JUNE 30 1987 <br /> 1986 1987 <br /> Facility $100.00 Facility $100.00 <br /> Tank # *Status Tank # *Status <br /> 1 A $ 50.00 1 A $ 50.00 <br /> -- PAYMENT <br /> RECEIVED <br /> -- - -- - - JUN 2 51987 <br /> State surcharges (@ $56 per tank x I = $ 56.00 ENVIRONMENTALP CES LTH <br /> Subtotal of permit fees 1986 $ 150.00 <br /> Subtotal of permit fees 1987 $ 150.00 <br /> TOTAL FEES DUE: $ 356.00 <br /> *A - Active <br /> TC - 'I'emporary Closure <br /> PC - I)ermanent Closure <br /> Notify the San Joaquin Local llealth District of any corrections or changes <br /> necessary . <br /> Return payment along with one copy of this statement to: <br /> San Joaquin Local Health District <br /> Environemntal Health Permit/Services <br /> P 0 Box 2009, Stockton , CA 95201 <br />