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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 Officer <br /> NBTRIPL37 <br /> Faith Transportation Faith Transportation <br /> 3755 Munford 3755 Munford <br /> .Stockton , CA 95205 Stockton , CA <br /> Billing statement for 1986 - 1987 Underground Tank Facility . <br /> Statement Date : September 15 1987 Date Due October 15 , 1987 <br /> 1986 1987 <br /> Facility $100 .00 Facility $100 . 00 <br /> Tank # *Status Tank # *Status <br /> 1 A_ 5 50 .00 1 A $_50 .00 <br /> 2 A 50 . 00 2 i A 50 . 00 <br /> State surcharges @ $56 per tank x 2 = $ 112 .00 <br /> Subtotal of permit fees 1986 $ 200 . 00 <br /> Subtotal of permit fees 1987 $ 200.00 <br /> TOTAL FINS DUE: $ 512 . 00 <br /> *A - active <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br /> Notify thc; S.cn Joaquin Local Elealth I)istrict of any corrections or changes <br /> necessary . <br /> Return payment alonJ; with one copy of this :states ont to : <br /> San Joaquin Local Health District <br /> Environemntal health Permit/Services <br /> lD 0 Box 2001) , Stockton , CA 95201 <br />