Laserfiche WebLink
PUBLIC HEALTH SERVICE';, SAN JOAQUIN COUNTY � <br /> 445 N. San Joaquin '_treet. (NOT A MAILING ADDRESS) � <br /> F ;i:• Box 2009 . <br /> St+ c ton, CA 95200 <br /> (209) 458-22'427 <br /> Jogi Khanna, M.D. , Health Officer L-3 <br /> I <br /> CAL IF33 <br /> <br /> <br /> STOC:K:TON, CA 95205 <br /> Billing Statement For 1992 Permit, Underground Tank: Facility . <br /> Stat&ft nt. Oat January- l0, ,n2 <br /> Payment Due Date; February 10, 1992 <br /> Container fee (1001 170.(x) <br /> I TOTAL FEES DUE --3170 OU <br /> I NOTES; <br /> Notify Public Health Services, <br /> — <br /> correct-iorFs or charges <br /> necessary. Your permit will <br /> be mailed upon receipt of <br /> Payment and approval of <br /> facility. Z. <br /> .APPROIVE® FOR PAYMENT <br /> Stuck.n - 265 <br /> I k {,4lCS�_pj�yment sTlot'F-3 <br /> with-.one, <br /> copy of this statement to: . . . . . . . ... . . . . . . . . . . .. 222. ... . . ..........•• + <br /> c F, I <br /> I <br /> PUBLIC HEALTH SERVICE'=; /T .. <br /> SAN ."OAQUIN COUNTY F.. . . .� .�. <br /> . . . . ... <br /> . . . . . <br /> I ENVIRONMENTAL HEALTH PERMIT/SERVICE' ' " " ' ° "�' <br /> I P.O. BOX 2009 >:_: <br /> STOC:KTON, CA 95201 . . . . . . . . fes, . Ca . . . . . . . . . . . .. . . . .. <br /> Dcea Gcod�fieceFviid <br /> I Penalties will be added after (!f Applicable) <br /> due d'a'te asm`shown: <br /> I 30 days - 100% of Base Fee <br /> PAYMENT l <br /> RECEIVED I <br /> f F[B 0 3 1992 <br /> SAN I PUBLIC HEAL H SERVICFS <br /> NVIRONMENTALHEALTIi Dt415i0,1 <br />