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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 466-6781 <br /> Jogi Khanna, N.O., Health Officer <br /> WOOLS36 <br /> WOOLSEY OIL, INC. WOOLSEY OIL, INC. <br /> <br /> STOCKTON, CA 95204 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: MAY 1 , 1987 <br /> Due: JUNE 1, 1987 <br /> Facility S 100.00 <br /> Container M "Status <br /> 1 A E 50.00 <br /> �— A E 50.00 <br /> A E 50.00 <br /> � PAYMENT <br /> RECEIVED <br /> $ JUL 91987 -7i�- <br /> State surcharges @ $56 per tank x _ = $ ENVIRONMENTAL HEALTH <br /> PERMITISERVICES <br /> Subtotal of permit fees: S 2gn nn <br /> Additional Billings or Credits <br /> Additional 1986 fees <br /> (2 tanks and surcharge 5 212.00 <br /> TOTAL FEES DUE: b 462.00 <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> past due date as shown: of any corrections or changes necessary. <br /> Permit will be mailed upon receipt of payment <br /> and approval of facility. <br /> 30 days - 100% of Base Fee Return payment along with one copy of this <br /> statement to: <br /> San Joaquin Local Health District <br /> Environmental Health Permit/Services <br /> A - Active P. 0. Box 2009, Stockton, CA 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />