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• { .ta:+[k i.ttitt (.H �;Zi'{li <br /> (209) 4W-3425 <br /> • ' Jagi 3�fitantt�i; M.D., 1ealtt, �o, PAYMENT <br /> RECEIVED <br /> TIKIL12 F E$ 0 9 1990 <br /> TIk:I LAWN EcESLI11 iRNJ ml YA SAV JOAQUIN COUNTY <br /> RD. 119138 W. INC N1t31'dA o PD PUBLIC HEALTHF.RVC,E'S <br /> 4i4 -3T�JCKTON, CH 3520f, ENVIRONMENTAL HEALTH UIViSION <br /> I <br /> Pilling Statextent For 1990 Permit, Underg=vund Tari:. Facility <br /> Statnt Datta 1 IanLaTy .i, 1:�:}t <br /> payotent Due Gate; February 2, iT30 <br /> Facility Fee; i K).0 <br /> Container- kluiGFr1 00-c .00 <br /> T OT AL FEE'3 0!E 00 <br /> WiTES: <br /> Notify Public N'ealt�: 't�r'UiieS, <br /> 10 +Da um County fat ibis' } �� <br /> :irr-ect.irns or [h;r1gf-' <br /> necessary. Your perms- will <br /> tie ti �rx xvx <br /> Payri=.ent and approval of <br /> f;Cility. <br /> Return payNent aio ng with one + <br /> [Cw,.y of this sta'1•er€,hitt• tc.: A# <br /> PUBLIC HEA"'! TH :3ERV11 =ES <br /> SAa JCIAWIN CCtUi iY <br /> rE NVIi OWIENTIAL KCALTP PUN I faEi?VIL:E's <br /> P.t-. EGX 2'109 <br /> L'!i)Ckl9i'M1 <br /> Pen=s1#•ies wall Lie added ati•ei <br /> due date as shrjwn. <br /> 30 days 100% c-i 3ase Fee <br />