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SAN SDAQUIN LUC:AL HEALTH DIE RIC:'i <br /> 1,601 E. Hazelton Ave. , P.O. Box 2009 <br /> Stockton, CA 95201 <br /> (20'3) ,468-3414 <br /> Jogi Khania, M.D. , Health Officer <br /> RU'fUR34 <br /> ROTO-ROUTER Rt BTU-NUUTE''R <br /> P 0 BOX 5543 2,0x* E. CARPENTER <br /> :STOCK ON, , CA 95105 STUCKTtIN, CA 95205 <br /> 'si'llung Statement. For 1909 Permit, Underground dant; Facility. <br /> Statement Gate January 1 , 1939 <br /> Payment. Due Gate, February 1, 19x9 <br /> Facility Fee; 100.00 <br /> Container Number% C=0.01 <br /> 0002 50.00 <br /> TOTAL FEE_ DUE $200.00 <br /> 1t iTE , <br /> Notify tie San Joaquin Local <br /> Health District of aiif <br /> cor'recti Gris or chan-pes <br /> necessary . Your Permit will <br /> be ma, lei, upon -receipt of <br /> payment. and approval of <br /> facility . <br /> Return payment alt+n9 with one <br /> coy of this statement to„ <br /> _AN JOAQUIN LOCAL HEALTH DISTRICI <br /> ENVIRONMENTAL HEATH PERM WSERVICES <br /> P.O. BUY, lilt 9 <br /> STOICK CJN, CA 9 101 <br /> Penalties will be added after <br /> due date as shown: <br /> 30 days - 1007, of Base Fee <br /> �I V <br />