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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, M.D. , Health Officer <br /> TRIVA25 <br /> Tri Valley Dairy, Inc. Tri Valley Wholesale <br /> P. 0. Box 8099 2525 S. Airport !day <br /> Stockton, CA 95208 Stockton, CA 95206 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: March 1.1987 <br /> Due: March 31, 1987 <br /> Facility $ 100 <br /> Container # Status <br /> 1 A $ 50 <br /> $ _ PAYMENT <br /> $ RECEIVE=D <br /> MAY 4 161 <br /> — — $ ENVIRONMENTAL HEALTH <br /> State surcharges @ $56 per tank x _ _ $ <br /> P_ERMITJSERVICES <br /> Subtotal of permit fees: $ 150 <br /> Additional Billings or Credits <br /> TOTAL FEES DUE: $ 150 <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> after 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 /> P. 0. Box 2009, Stockton, CA 95201 <br />