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SAN JOAt3�., LOCAL, HEALTH DI"oIRIC:1 o,..J <br /> 1501 E. Hazelton Ave. , P.O. Box 2005 <br /> Stockton, CA 95201 <br /> (20'9) 463-3425 <br /> Jogi Khanna, M.D. , Health Officer <br /> MEADOI2 <br /> CLOVER MEADOW DAIRY CLOVER MEADOW DAIRY <br /> <br /> ESCALON, CA 95320 <br /> Billing Statement For 1959 Permit., Underground Tank Facility. <br /> Statement Date ; August. 1, 1939 <br /> Payment. Due Date; September i , 1959 <br /> Previous Balance 112.00 <br /> Facility Feei i00.00 <br /> Container Number: 0001 50:00 <br /> 0002 50.00 <br /> TOTAL FEES DUE $312.00 <br /> NOTES: <br /> Notify the Sar, Joaquin Local <br /> Health District of any <br /> corrections or changes <br /> necessary . Your permit will <br /> be mailed upon receipt of <br /> payment- and approval of <br /> facility. <br /> Return payment along with one <br /> copy of this statement to: <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH PERMIT/SEP,VICES <br /> P.O. BOX 2009 <br /> STOCKTON, CA 95201 <br /> Penalties will be added after <br /> due date as shown: <br /> 30 days _ 100% of Fuse Fee <br /> V <br />