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SAN J!"04 LOCAL HEALTH DISTRICT • <br /> 1601 E. Hazelton Ave. , P.O. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 463-3425 <br /> Jogi Khanna, M.D. , Health Officer <br /> LAGOMGO <br /> LAGOMARSINO BROS. LAGOMARISO BROS. <br /> 6040 E. MAIN 6040 E. MAIN <br /> '_TOC:KTON, CA 952105 S OC:KTON, CA 95205 <br /> Billing Statement For 1909 Permit, Underground Tank Facility . <br /> Statement Date August 1, 1939 <br /> Payment. Due Date: September 1 , 1909 <br /> Previous Balance 56.00 <br /> Facility Fee: 100.00 <br /> Container Number; 0001 50.00 <br /> TOTAL FEES DUE `Q206.00 <br /> NOTES; <br /> Notify the Sar, Joaquin Local <br /> Health Distract of any <br /> corrections 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 JDAQUIN LOCAL HEALTH DISTRICT - <br /> ENVIRONMENTAL HEALTH PERMIT/SERVICES <br /> F' O. BOY 2009 <br /> STOCKTON, CA 95201 <br /> Penalties will be added after <br /> due date as shown: <br /> 30 days - 100% of Base Fee <br />