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\..01 <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1501 E. Hazelton Ave. , P.O. box 2009 <br /> Stockton, CA 55201 <br /> (205) 468-:3425 <br /> Jogi Khanna, M.D. , Health Officer <br /> R IC:KS26 <br /> HOWARD E. RICHARDSON RICKS NORWALKS SERVICE <br /> 2662 N. WILSON WAY 2662 N. WILSON WAY <br /> STOCKTON, CA 95205 STOCKTON, CA 35205 <br /> Filling Statement. For 1980 Permit, Underground Tank Facility . <br /> Statement Date January 15, 1933 ' <br /> Payment Due Date; February 15; 1505 <br /> Previous Balar,._e 512.00 <br /> Facility Fee: 100.00 <br /> Container Number; 0001 50.00 <br /> 0002 50.00 <br /> TOTAL FEES DUE x+712.00 <br /> NOTES: <br /> Notify the San Joaquin Local <br /> Health District of any <br /> correct•io"s or changes <br /> necessary . Your permit will <br /> be mailed upon receipt of <br /> payment and approval of <br /> facility. <br /> Return payment along with one <br /> copy of this statement to: <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH PERMITISERVICES <br /> P.O. BOX 2009 <br /> STOCKTON, CA 95201 <br /> Penalties will be added after <br /> due date as shown; <br /> 10 days - 100'% of Base Fee <br />