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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Avenue , P O Box 2009 <br /> Stockton, CA 95201 <br /> (209)466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> • <br /> <br /> 708 E. PARK ST. <br /> STOCKTON, CA 95202 <br /> Billing statement for 1986 & 1987 Underground Tank Facility . <br /> Statement Date: MAY 20 1927 Date Due JANE 30, 1987 <br /> 1986 $100 1987 $100 <br /> Facility Facility <br /> Tank # *Status Tank # •Status <br /> 1 A S 50 1 A $_50 <br /> State surcharges $56 per tank x 1 $ qA nn <br /> Subtotal of permit fees 1986 $ 150.00 <br /> Subtotal of permit fees 1987 $ <br /> 150.00 <br /> TOTAL FFIES DUE: $ 356.00 <br /> • A - Active <br /> 'fC - '1•emporary ClOsurC <br /> PC - PCrmanent Closur(• <br /> Notify the San Joaquin Local Ifealth District of any correction:: or change~ <br /> neceti:ra ry . <br /> Heturn payment along wiLh onC 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 />