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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 Office;- <br /> • STC)CKTON-EAST WATER DISTRICT NBSIOCK67 <br /> P.O. BOX 5157 STOCKTON-EAST WATER DISTRICT <br /> STOCKTON, CA. 95205 6767 E. MAIN ST. <br /> SIC)CKTON, CA. 95205 <br /> Billing statement for 1986 - 1987 Underground Tank Facility . <br /> Statement Date : AUG. 25, 1987 pate Due S.1.71'. 25, 1987 <br /> 1'986 1987 <br /> Facility $100.00 Facility $100.00 <br /> Tank # *Status Tank # *Status <br /> _ 1 A 50 1 A S 50 <br /> 2 A 50 2 A 50 <br /> 3 A 50 3 A 50 <br /> State surcharges $56 per tank x 3 = $ 168.00 <br /> Subtotal of permit fees 1986 $ 250.00 <br /> Subtotal of permit fees 1987 $ 250.00 <br /> 'rOTAL F1.ES DUE: $ 668.00 <br /> *A - Active <br /> TC - Temporary Closure <br /> PC, - Permanent. Closure <br /> Notify t.trc San Joaquin l,()e:al Health l)i :;tr is t of any (,orroctlons or changes <br /> WIC S:;;k r'y . <br /> lteturn payment along; wi t!r oric copy of thi .; t;tatollwrit t.() : <br /> ,;;In Joaquin Local Health Di !;tric.t <br /> E'nvironemntal Health Perini t/Services <br /> l) 0 Box 2009 , Stockton , CA 9521 )1 <br />