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0 a <br /> 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 /> .GOEHRING MEAT INC. GOEHRI8 <br /> P. 0. BOX 147 GOEHRING MEAT INC. <br /> LODI, CA 95241 • 18846 N. HIGHWAY 99 <br /> LODI , CA 95240 <br /> Billing statement for 1987 PERMIT Underground Tank Facility. <br /> Statement Date: <br /> Due: MAY 15, 1987 <br /> Facility $ 100 <br /> Container # *Status <br /> L A 50 <br /> A_ $ � <br /> State surcharges @' $56 per tank x - PAYMENT <br /> RECEIVE© <br /> Subtotal of permit fees: $ 250.00 MAY 16 ]Jb <br /> Additional Billings or Credits <br /> ENVIRONMENTAL HEALTH <br /> $ PERMIT/SERVICES <br /> TOTAL FEES DUE: $_250_.00 <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 /> 30 days - 100% of Base Fee and approval of facility. <br /> 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 /> I <br />