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i I <br /> PUBLIC: ALTH SERVIC:Es, SAN JCIA(,UIN COILN, f <br /> 44S N. Sari 7aaquin Street VOT A MAILING ADDRESS) <br /> P.O. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 468-3421 I <br /> Jogi Khanna, M.D. , Health Officer I <br /> � I <br /> TAKAH13 <br /> RUN 'fAKAHASHI SHELL RON TAKAHASHI SHELL � <br /> 1313 E. CHARTER WAV 1313 E. CHARIER WAY <br /> STOCKTON, CA 9S20S STOCKTON, CA 95205 I <br /> I I <br /> Billing statement. For 1991 Permit., Underground Tank Facility . <br /> Statement. Date January 7, 1991 <br /> Payme-,t. Due bate; February 1, 1991 <br /> I <br /> --------- <br /> TOTAL FEES Disc $0.00 <br /> I � <br /> Ii <br /> I <br /> I I <br /> NOTES: <br /> Notify Public Health Services, <br /> San Joaquin County of any I <br /> corrections or changes <br /> I necessary . Your permit will <br /> I he mailed upon receipt of <br /> payment and approval of 1 <br /> facility . <br /> II Return payment. along with one <br /> copy of this statement to; <br /> PUBLIC: HEALTH `,SERVICES � <br /> SAN JOAQUIN COUNTY <br /> I ENVIRONMENTAL HEALTH PE.Rt"AVERVICES <br /> P.O. BOX 2009 <br /> STOCKTON, CA '92;201 <br /> Penalties will be addad after II <br /> due date as shown; I <br /> 30 days - 100% of Base Fee <br /> I � <br /> I � <br /> I I <br /> I I <br /> I I <br /> I I <br /> I i <br />