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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Avenue, P 0 Box 2009 <br /> Stockton , CA 95201 <br /> (209)466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> CRAIG C. JOHNSON MISSIIO <br /> P.O. BOX 1421 MISSION GROCERY <br /> PLEASANTON, CA 94566 10217 N. HWY 99 <br /> STOCKTON, CA 95212 <br /> Billing statement for 1986 - 1987 Underground Tank Facility . <br /> Statement Date: May 11 , 1987 Date Due May 30, 1987 <br /> 1986 1987 <br /> Facility $100.00 Facility $100.00 <br /> Tank # •Status Tank # *Status <br /> —2A go- 0 _2— A _50_00 <br /> State surcharges 0 $56 per tank x_ 2 $ 112.00 <br /> Subtotal of permit fees 1986 $ 200.00 <br /> Subtotal of permit fees 1987 $ 200.00 <br /> TOTAL FEES DUE: $ 912.00 <br /> `A - Active <br /> TC - Temporary closure <br /> PC - Permanent ui osurc <br /> Nosily the San Joaquin I.o(:al Health District o1' any corrections or changes <br /> nece:;:;a ry ,. <br /> Return payment along; with one copy of this statement to: <br /> San .loayuin Local Ilealth District <br /> Environemntal Ilealth Permit/Services <br /> P 0 Box 2009, Stockton , CA 95201 <br />