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• <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 />. UNION27 <br />UNOCAL UNION OIL SS#5886 <br />2175 N CALIFORNIA BLVD. STE. 650 2701 W MARCH LANE <br />WALNUT CREEK, CA 94596 �STOCKTON, CA 95207 <br />Billing statement for 1987 Permit , Underground Tank Facility. <br />Statement Date: March L5, 1987 <br />Due: April 15 1987 <br />10 <br />Facility 0� <br />Container # Status <br />1 A <br />3 A _ APP`°ve4 for P a 01 <br />2 <br />50 <br />State surcharges @ $56 per tank x <br />Subtotal of permit fees: $250 <br />Additional Billings or Credits <br />$izLf <br />TOTAL 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 />0 - 9 <br />