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SAN JOALUIN LOCAL HEALTH DISTRICT <br /> 160t E. Hazelton Ave. , P.+l. Brix 20054 <br /> 8t.ocl.-ton, CA %201 <br /> (LU'71 468-3415 <br /> ,logi Khanna, M.D. , Health Officer. <br /> CASTL01 <br /> <br /> <br /> TRACY, CA 95376 <br /> a <br /> j Billing Statement For 1983? Permit, i:rde'pground Tank Facility . <br /> Statement. Date January 1 , 198''J <br /> F'ayrient. Due Date; February 1 , 1989 <br /> Facility Fee: 100.00 <br /> Container Number: 0001 50.00 <br /> "TOTAL FEES DUE $150.00 <br /> NOTES. <br /> Notify the Sar 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 /> facIIit.y . <br /> Return payii ent along with one <br /> copy of this stateriient to: <br /> SAN j6RcCUIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH PERM!TISERVICEB <br /> P.O. BOX 10054 <br /> STOCKTON, CA 95201 <br /> renalties will ber.dded after <br /> due date as shown: <br /> 30 days - 100% of Base Fee <br />