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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton, CA 95201 <br /> . (209) 466-6181 <br /> Jogi Khanna, M.D. , Health Officer <br /> UNION73 <br /> UNION OIL SS#5421 <br /> UNOCAL7303 PACIFIC AVE . <br /> • 2175 N CALIFORNIA BLVD . STE . 654 . 7303 AC CA 65207 <br /> WALNUT CREEK, CA 94596 <br /> Billing statement for 1981 Permit Underground Tank Facility. <br /> Statement Date: March 1.5 19$7 <br /> Due: !April 15,. .1987 <br /> Facility $ <br /> Container # *Status <br /> 1 A5J <br /> 2 <br /> A <br /> 3 A 1201— <br /> State surcharges @ $56 per tank x <br /> Subtotal of permit fees: <br /> Additional Billings or Credits <br /> $ $ 2w.00 <br /> TOTAL FEES DILE: <br /> Notify the San Joaquin Local Health District <br /> Penalties will be added <br /> after due date as shown: of any corrections or changes necessary. <br /> permit will be mailed upon receipt of payment <br /> and approval of facility. <br /> 30 days - 100% of Base Fee Return payment along with one copy of this <br /> statement to: <br /> San Joaquin Local Health District <br /> Environmental Health Permit/Services <br /> * p. 0. Box 2009, Stockton, CA 95201 <br /> A -Active <br /> TC - Temporary Closure <br /> PC Permanent Closure <br />