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SAN JOAQUIN LOCAL HEALTH DISTRICT ISL 9✓✓ /z' <br /> 1601 E. Hazelton Ave. , P.O. Box 2009 AFq0 11l FQ <br /> Stockton, CA 95201 <br /> Je,3i Khann(209)u468-3425 Officer /%SF'-9lyl J <br /> oes �lTy <br /> TAKAH13 <br /> RON TAKAHASHI SHELL RON TAKAHASHI SHELL <br /> 1313 E. CHARTER WAY 1313 E. CHARTER WAY <br /> STOCKTON, CA 35205 STOCkTON, CA 95205 <br /> illing Statement. For 1989 Permit, Underground Tank Facility . <br /> Statement Date ; January_ _1, 1989 <br /> Payment. Due Date; February 1 , 198; <br /> Facility Fee; 100.00 <br /> Container Number; 0001 50.00 <br /> 0002 50.00 <br /> 0003 50.00 <br /> TOTAL FEES DUE $2.50.00 <br /> Ifr <br /> E,}; <br /> Notify the San 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/SERVICES <br /> P.O. BOX 2009 <br /> '=TOCKTON, CA 95201 <br /> Penalties will be added after <br /> due date as shown; <br /> 30 days - 100% of Base Fee <br />