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i 46 <br /> 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 /> LOUIS MOLIN r4OLIN43 <br /> . P. 0. BOX 7433 LOUIS MOLIN <br /> . STOCKTON, CA 95207 435 S. WILSON WAY <br /> • STOCKTON, CA 95205 <br /> Billing statement for 1986 & 1987 Permit Underground Tank Facility . <br /> Statement Date: AUGUST 10, 1987 Date Due SEPTEMBER 10, 1987 <br /> 1986 1987 <br /> Facility 100.00 Facility <br /> Tank # *Status Tank # *Status <br /> 1 A g 50 1 PC g 90 <br /> State surcharges $56 per tank x 1 = $ 56.00 VNO <br /> Subtotal of permit fees 1986 $ 15f1_M <br /> Subtotal of permit fees 1987 $ 90.00 <br /> TOTAL FEES DUE: $ 296.00 <br /> *A - Active <br /> TC - Tempor.c ry C 1 osu re <br /> RC - Permanent Closure <br /> Notify the San Joaquin Local health District of any Corrections or changes <br /> necery . <br /> Return payment along with one copy of thin statement to : <br /> San Joaquin Local health District <br /> Environemntal health Permit/Services <br /> P 0 Box 2009 , Stockton , CA 95201 <br />