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• i <br /> 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 /> . B. & A. McKinnon • DELTAI6 <br /> . P. 0. BOX 9352 DELTA PALLET SERVICE <br /> . STOCKTON, CA 95208 1624 NAVY DRIVE <br /> STOCKTON, CA 95206 <br /> Billing statement for 1986 - 1987 , Underground Tank Facility . <br /> Statement Date: JULY 21, 1987 Date Due AUGUST 21, 1987 <br /> 1986 $100.00 1987 $100.00 <br /> Facility Facility <br /> Tank # *Status Tank # *Status <br /> — PAYMENT <br /> RECEIVED <br /> AUG 2 a 1 1987 <br /> State surcharges @ $56 per tank x 1 = $ 56.00 )ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> Subtotal of permit fees 1986 $150.00 <br /> Subtotal of permit fees 1987 $150.00 <br /> TOTAL FRES DUE: $ 356.00 <br /> *A - Active <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br /> Notify the San Joaquin Local Health District, of any corrections or changes <br /> necessary . <br /> Return payment along with one copy of this statement to: <br /> San Joaquin Local Health District <br /> Environmental Health Permit/Services <br /> P 0 Box 2009, Stockton, CA 95201 <br />