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SAN :IOA(lUIN LOCAL HEALTH DISTRICT <br /> 1501 E. Hazelton Ave. , P.O. Box 1009 <br /> Stockton, CA 55201 <br /> (2091 453-3+115 <br /> .yogi Khanna, M.D. , Health Officer <br /> CARNEQ <br /> PARKS RECREATION C'ARNEGIE SVRA <br /> <br /> TRACY, , CA 95375 <br /> Bi i 1 ing Statement For 1905 Permit, Underground Tani:: Facility . <br /> Statement Date ; 3anuary 1, 1939 <br /> Paynent. Due Date; February 1 , 1535 <br /> Facility Fee; 100.00 <br /> Container Number; 0001 SO.00 <br /> 0002 50.00 <br /> TOTAL FEES DUE $200.00 <br /> NOTES; <br /> Notify the San joaquin Local <br /> Health Oistrict 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 DISTRIC`t <br /> ENVIRONMENTAL HEALTH PERMIT/SERVICES <br /> P.O. BOX 1005 <br /> STOCKTON, CA 9S201 <br /> Penalties will be added after <br /> due date as shown; <br /> 00 ;days - 100% of Base Fee <br />