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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 /> <br /> <br /> LODI , CA 95240 <br /> Billing statement for 1987 Underground Tank Facility . <br /> Statement Date: September 15, 1987 Date Due October 15, 1987 <br /> Facility $100.00 <br /> Tank # *Status 'tank # *Status <br /> 1 A S 50_00 S <br /> k4O.&T 1 e 1987 <br /> State surcharges $56 per tank x_= $ ENVIROMENTAL H <br /> FERMIVSERVICES TH <br /> Subtotal of permit fees 1987 $ 150.00 <br /> TOTAL FEES DUE: $ 150.00 <br /> *A - Active. <br /> '1'C - Tomporary Closure <br /> PC - P' 'rmanent Closure <br /> Notify Lhu San Joaquin Local Ilealth Dl :;trict. of :Lily corrections or chane;(!!; <br /> ncce�c;ary . <br /> Itctwn payment alone wtt.h on(• copy of thi:; :statement to : <br /> San Joaquin Local Health Di:;trict <br /> Environemntal Health Permit/Services <br /> P 0 Box 2009 , Stockton , CA 95201 <br />