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' PUBLIC HEALTH SEPwrES, SAN DOWN COUNTY <br /> 4 = D-ol E. Hazel�lve., P.U. Box 2009 <br /> Stockton, CA S6201 <br /> (205) 4593-3425 <br /> Jogi Khanna, K.D., Health Officer <br /> TAKAHI3 <br /> 111;1V iar;pHASHl +#Ll RON TAKAHASHI SHFLL <br /> ,313 E. CHARTER WAY 1313 E. CHARTER WAY <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> Billirv; Statement For 1550 Perc,it, Undergrcaid Tank Facility. <br /> Statement. Cate ; January 2, 1950 <br /> Payment Due Date; February 2, 1990 <br /> Facility Fee; 100.00 <br /> TOTAL FEES M $100.W <br /> o�> <br /> KITES; <br /> Notify Public Health Services, <br /> San Joaquin County 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 /> PUBLIC HEALTH SERVICES <br /> SAN JOWIN MINTY <br /> EWIRWIENTAL HEALTH PERMIT/SERVICES <br /> P.0. BOX 2(0 <br /> :iTOCKTON, CA 95201 <br /> Penalties will be added after <br /> due date as shown; <br /> a0 days - 100% of Base Fee <br />