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PUBLIC HEALTW�div ICESS, JOAQUIN C.COUNTY <br /> -4 1 -'NI3T A MAILING ADORES'S" <br /> N. can joaquin St. 11 <br /> Bo".. <br /> 4E' 42 <br /> -1,71-9i Khanna. M.D. , Health Officer <br /> DIS <br /> 'T. <br /> ESCALON UNIFIED SCHOOL Q1z--;T '-'A' ON UNIFIED '3CHOOL <br /> ! AU.- <br /> VS,20 YOSIEMITE AVENUE <br /> ESCALON1, C '9461 32'() 0 <br /> May 7, <br /> 3-11 j-=1juary 3.. 1'14'331 the above facility was billed, fow an <br /> ank F--cii-tv . TI- J5 fee i� or your requred Permit to <br /> Jz 3y 1 1991 to O'ceff" -r •�'1 , I' <br /> for the --�,ricl tnu:i <br /> 1'd C- i-, — . <br /> Perialtirc-:-B were a0ded to the rate of 100% of the 1pa5t du__' amou-Flt <br /> as of March 3., 1991 The amount now due -nnd Payable is 415-1-2-' <br /> If payment has beeD sent., please disregard thi��' notice. Should you 1-jave an'-Y <br /> questions regardiln-:i this billing state-ment, please contact this office at <br /> 0'9) 468-3426 between E-;:00 A.M. and ;:00 P.M. <br /> Notify Public Health Services.. <br /> corrections or changies <br /> Ecce --y 'four e'er Tflit will <br /> b---- malLled Upok' of <br /> Pm�yrflerftl arld approval of <br /> facility . <br /> Ret. rn �,ayiment• along with one <br /> Cnpy oj *his stateff-tent Kto- <br /> I"UIC. HEALTH .".ERVI, r <br /> SAN jOAQUIN CCIUNTY <br /> ENVITRi-NMENTAL HEAL.-17H PERMIT 'SERVIU-c <br /> i t <br /> ,!)'X 210013 <br />