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SAN Ji=�H=�t;IN LOCAL HEAL ��T'�Th1CT <br /> 1601 E. Hazai}�Jn Ave. , Y.O. Sox 20094 <br /> Stock t.on, CA X01 r: <br /> JG' 1 <br /> Khanna, M.D. , Heal t•il Of f i c er <br /> SUNK 15 <br /> E_Z_ `EDRVF, INC:. SUNRISE MARKET LIQ11,11R��-%��QT <br /> P. 0. BOX 3151150 9S2 S. WIL"_i N WAY <br /> ONTARIO, CA 91751 STOCKTON, CA ' 9521:5 <br /> Billing 'Staterflent• For Per Fiji t•, UnIJ;et-,_lrou ,d Tank. Facility. , <br /> ,tateti:wilt.I7ate January -I5 - <br /> -- JPayment. Due Date� February 15, <br /> Facility Fee; 100,00 <br /> Container Number: 0001 50.00 ' <br /> 000:3 so.o(i <br /> TOTAL, FEES DUE $`2SO.00 <br /> NOTES <br /> Notify the San Joaquin Local <br /> HL-aIth District of any <br /> corrections ctr changes <br /> necessary. -Your permit will <br /> be mailed upon ,receipt of . <br /> payment and approval of <br /> facility. _ <br /> -RPt.urn' P;4yslent.'aI6-14 with onc <br /> copy of this statement to: <br /> SAN JOA1QUIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HE;LTH PERMIT/SERVICES <br /> P,0. 60X 200« <br /> STOCKT01N, -CAI X52,01 1 <br /> Penalties Will- be caddied after <br /> due date' a� SI 11JWI-I i � - <br /> 3a days '100% of Base Fee } . <br />