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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 /> CITY OF STOCKTON • PO•LIC22 <br /> 425 N EL DORADO - CITY OF STOCKTON-- POLICE DEPT. <br /> STOCKTON, CA 95202 • 22 E MARKET ST. <br /> - STOCKTON, CA 95272 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: March 1987 <br /> Due: _ xil 1_5,.1987 <br /> Facility $ 100 <br /> Container # *Status <br /> 1 A � <br /> 2 A 50 <br /> 3 A 50 PAYMENT <br /> RECEIVED <br /> -- - -- APR 1987 <br /> State surcharges @ $56 per tank x _ _ $ ]ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> Subtotal of permit fees: $250 <br /> Additional Billings or Credits <br /> TOTAL FEES DUE: $ 25'3'()0 <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 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 /> A - Active P. 0. Box 2009, Stockton, CA 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />