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SAN JOA( IUIN LOCAL HEALTH DISTRICT <br /> 16=01 E. Hazelton Ave.`, P.O,- Bov"'2009 3 <br /> Stockton, CA 95:01 <br /> (209) 468-3426 <br /> Jogi Khanna, M.D. , Health Officer <br /> LAGOMG0' <br /> LAGOMARSINO BROS. LAGOMARISO BROS. <br /> 6040 E. MAIN 6040 'r . MAIN <br /> STOCKTON, CA 9S20S STOCKTON, CA 95205 <br /> Billing St•at.ement. For 1909 Permit, Underground Tank Facility . <br /> Statement. Date iuly 1, YLQi �- <br /> Payment. Due Date; Au•aust 1 , 1989 <br /> Facility Fee: 000.00 <br /> Container Number: 0001 50.00 <br /> TOTAL FEES DUE A $150.00 <br /> NOTES: <br /> Notify the San Joaquin Local <br /> Health District of any <br /> corrections or changes <br /> necessary . Your permit will <br /> be trailed 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 PERMIT/SERVICES <br /> F.U. BOk 2009 <br /> STOCKTON, CA 95201 <br /> Periaat.ies wil.i be added after <br /> due date as show{:; <br /> 30 days - 100'7, of Base Fee <br /> , <br />