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0 <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 /> STOCKTON-EAST WATER DISTRICT •NBSTOCK67 <br /> P 0 BOX 5157 STOCKTON-EAST WATER DISTRICT <br /> STOCKTON , CA 95205 6767 E. MAIN ST. <br /> • STOCKTON, CA 95205 <br /> Billing statement for 1986-1987 , Underground Tank Facility . <br /> Statement Date : Sept . 30 , 1987 Date Due October 30 , 1987 <br /> x9$6 1987 <br /> Facility $100 . 00 Facility $ 00 .00 <br /> Tank # *Status Tank # *Status <br /> -._. _.A -A- b- 50 <br /> 3 A . ) PAYMENT <br /> 'RECEIVED <br /> N OV I 12d 1987 <br /> ENVIRONMENTAL HEALTH <br /> State surcharges @ $56 per tank PERMIT/SERVICES <br /> Subtotal of permit fees 1986 $ 250 .00 <br /> Subtotal of permit fees 1387 $ ?50. 00 <br /> TOTAL. FEES DUE: $ 668 . 00 <br /> *A - Active <br /> TC - Temporary Closur(' <br /> ht" - Pormanent. ("'losurf. <br /> Notify the ,)':cr► .1():iqu111 Imcal Ifc°:►I t h l)t :.tric:t of any corrections or chango-, <br /> Return payment along with 0110 COPY of, tltis statement to: <br /> :;an .1oaclu i n l,oc,al Health District <br /> Environemntal Health Permit/Services <br /> 1; 0 Box 2009 , Stockton , CA 95201 <br />