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PUBLIC HEALTH SERVICES �oP to <br /> SAN JOAQUINCOL NTY <br /> JOGI E:HAVNA M.D.K P H Lek <br /> Heelth Officer <br /> C�P <br /> P.O. Box 2009 • (1601 East Hazelton Avenue) • Stockton, California 95201 Oct FOR`' <br /> (209) 468-3400 <br /> James Meservy <br /> <br /> <br /> CHEVR10 <br /> BILLING STATEMENT <br /> UNDERGROUND STORAGE TANKS <br /> FACILITY LOCATION: 103 E. Eleventh St. , Tracy. <br /> Billing for 1990 fees for permit to own and/or operate an <br /> Underground Tank Facility. (1990 permit fees and penalty) <br /> Statement Date: August 2 , 1991 <br /> Payment Due Date: upon receipt <br /> Facility Fees: $ 100. 00 <br /> Container Fees: <br /> Tank 0001$ 50. 00 <br /> Tank 0002 50. 00 <br /> Tank 0003 50. 00 <br /> Tank 0004 50. 00 <br /> 1990 Penalty <br /> Fee: 300. 00 <br /> TOTAL AMOUNT OF FEES DUE: $ 600. 00 <br /> If you have any changes or <br /> corrections please call our <br /> office when statement is <br /> received at (209) 468 3427. <br /> Please remit with payment one copy of this <br /> statement to : <br /> PUBLIC HEALTH SERVICES/ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009 <br /> STOCKTON, CA 95201 <br /> Division of tiara Joaquin Cnunry HcWth(:are-services <br />