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a!!� <br /> F <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P.O. Box 2W) <br /> Stockton, CA 55101 <br /> (209) 468-:3425 <br /> Jogi Khanna, M.D. , Health Officer <br /> GOLD BOND BUILDING PRODUCTS GOLDS80 _ <br /> SGOLD BOND BUILDING PRODUCTS <br /> STOCKTON, <br /> W. CHURCH:H ST. 800 W. CHURCH ST. <br /> CC'A9S203 <br /> STOCKTON, CA 95203 <br /> willing St•at•ement. For 1989 Permit, Underground Tank Facility, <br /> Statei:ent. Date .January 1, 1989 <br /> Payment Due Date; February 1, 1989 <br /> Facility Fee; 100.00 <br /> Container Number: 0001 <br /> 50.00 <br /> 0002 50.00 <br /> 0003 50.00 <br /> TOTAL FEES DUE - $250.00 <br /> NOTES: <br /> Notify the San Joaquin Local <br /> Health District of any <br /> cOr Pectio'ns 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 PERMITISERVICES <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 Base Fee -- <br /> �.!• - - <br />