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SAN ,t0 Q4'..'CRL HEALTH DISTRICT <br /> in01 [ Ha toil Ave. , P.11. Box 10C19 <br /> C'Uockton' C1 <br /> Ir <br /> dogi Khanna, M.D. , health Officer L .� <br /> H0FFM25 +' <br /> s- <br /> PAUL HOF AN g SONS PAUL HOFFMAN S SONS <br /> _6577 ':`NTA 677 S. BANTA OAD. Bm1 <br /> 1Z <br /> TRACY, CA 3c.7TRACY CA 35376 <br /> filling Statement. For 13c,3 Permit., UUC—r'gj'"und Taro; Facility . <br /> � F . <br /> Statement Date August 11 1989 <br /> Payment flue Date; September 1 , 1989 <br /> _ Previous Balance = 4•Cjrj <br /> Facility Fee. 1iJ`7 S)C' <br /> r' <br /> Cc,ntainer Number: 0001 U.CiCj <br /> 0002 5U.00 <br /> 00013 50.00 <br /> C -4 50.00 <br /> T+i I AL FEES DUE $524.00 <br /> OTES: <br /> ivc+t.ify the Sari .jea=uiri Local <br /> Health District of _11y <br /> coy rections or chaii9c5 <br /> necessary . Your permit 'x'711 <br /> be tisailed upon receipt of <br /> payment and approval of <br /> faciiit•Y . <br /> Return paYr,ent along with one <br /> co;Py of this statement to: <br /> SAU"dl.1AQ.UiN LOCAL HEALTH DISTRICT <br /> ENY''IROMIM NTAL HEALTH PERMITISERVICES <br /> P.O 'MmY 200' <br /> ::TOCKTON, CA 35201 <br /> penalties w: 11 be added after <br /> - due date _.- shotwm <br /> 30 dais - 100% of Base. Fee <br />