Laserfiche WebLink
SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> TIME OIL COMPANY . JACKP15 <br /> 2737 W COMMODORE WAY , JACKPOT <br /> SEATTLE, WA 98199 , 1554 W YOSEMITE <br /> MANTECA, CA 95336 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: MAY 7 1987 <br /> Due: June 1, 1987 <br /> Facility $100 <br /> Container # Status <br /> 1 A $Sn <br /> 2 <br /> 3 A. $.9r) PAYMENT <br /> RECEIVED <br /> $ MAY 19 1937�s/1�— <br /> State surcharges @ $56 per tank x ENVIRONMENTAL HEALTH_ = �_ PERMIT/SERVICES <br /> Subtotal of permit fees: $ 250 <br /> Additional Billings or Credits <br /> TOTAL FEES DUE: $250. 00 <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> after due date as shown: of any corrections or changes necessary.- -- <br /> Permit <br /> ecessary♦ --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 /> San Joaquin Local Health District <br /> Environmental Health Permit/Services <br /> P. 0. Box 2009, Stockton, CA 95201 <br />