Laserfiche WebLink
• <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 /> • Mr. Robert Griffin • WICKEI2 <br /> • 119 N. Crescent Avenue 1240 E. PINE ST. <br /> • Lodi , CA 95240 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 N *Status Tank # *Status <br /> 1 _ A S 50_00 — E <br /> PAYMENT <br /> RECEIVED <br /> OCT Ih1987 <br /> State surcharges @ $56 per tank x_= $ .ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> Subtotal of permit fees 1987 $ 150.00 <br /> TOTAL FEES DUE: $ 150.00 <br /> *A - Active <br /> TC - Tomporary CIosurc <br /> PC - Permanent Closure <br /> Notify the San .Joaquin Local Ilealth DistricL of any corrections or changes <br /> n(•Cas:r.iry . <br /> RO Lurn paymenL along with one copy of this statement to: <br /> San Joaquin Local Ilealth District <br /> Environemntal Health Permit/Services <br /> P 0 [lox 2009, Stockton , CA 95201 <br />