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1 - <br /> 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 /> ESCALON BEACON ESCALI3 <br /> 1305 ESCALON AVENUE ESCALON BEACON <br /> ESCALON, CA 95320 1305 ESCALON AVENUE <br /> ' ESCALON, CA 95320 <br /> Billing statement for 1987 Perm.It , Underground Tank Facility. <br /> 1 Statement Date: APRIL 1, 1987 <br /> Due: MAY 1, 1987- - <br /> Facility 100 <br /> Cont4iner *Status <br /> —7– 7- <br /> State surcharges @ $56 per tank x <br /> Subtotal of permit fees: $250 00 <br /> Additional Billings or Credits <br /> f <br /> $ <br /> ITOTAL FEES DUE- $ 250.00 <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 /> 1 <br />