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PUBLIC HEALTH _ 'CES, SAN J�OAQUIN C(WiiY ' <br /> 1601 E. Haz�b n Ave., P.O. Box 2009 1.04 <br /> Stockton, CA 95201 <br /> t209i 465-3425 <br /> -'Ni KI'alxa, M.D., Health Officer <br /> WILLIAM RELF SIMPS40 <br /> 4025 C� AVENUE J.H. SIMP N COMPANY <br /> SMTON„ CA 95204 40`5 C tC�4CNO AVENUE <br /> ST,CKTON,, CA 950 4 <br /> Billing Statement For 1990 permit, Urxlergrcuid Tank Facility. <br /> Statement Date : January 2, 1990 <br /> Payment Due Date; February 2, 1990 <br /> Facility Fee: i00 <br /> Container Number: 0001 so.00 <br /> TOTAL FEES UB $150 00 <br /> NOTES; <br /> Notify public Health Services, <br /> San Joaquin County of any <br /> Corrections or chanes <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 /> ?tBSLIC HEALTH SERVICES <br /> SAN JOAt 11N C:CWY <br /> ENVIRONMENTIAL HEALTH PERMIT/SERVICES <br /> P.D. BOX 2019 <br /> STOCKTON, CA 95201 <br /> Penalties will be add,:d after <br /> due date as shown: <br /> 30 days - 100% of Base Fee <br />