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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton , CA 95201 <br /> (209) 466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> RIPON MILLING COMPANY RIPON32RIPON MILLING COMPANY <br /> P.O. BOX 698 320 SOUTH STOCKTON <br /> RIPON, CA 95366 RIPON, CA 95366 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: 1987 <br /> Due: NE 1. 1987 <br /> Facility $ 100.00 <br /> Container # *Status <br /> —�-_ A S 50,00 <br /> PAYMENT <br /> RECEIVED <br /> JU1"1 2 1987 <br /> State surcharges @ $56 per tank x - <br /> ENVIRONMENTAL HEALTH <br /> Subtotal of permit fees: S 200.00 PEq[T/SERVICES <br /> Additional Billings or Credits <br /> 5 <br /> TOTAL FEES DUE: 5 200.00 <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> past due date as shown: of any corrections or changes necessary. <br /> Permit will be mailed upon receipt of payment <br /> 30 days - 100% of Base Fee and approval of facility. <br /> Return payment along with one copy of this <br /> statement to: <br /> San Joaquin Local Health District <br /> Environmental Health Permit/Services <br /> A - Active P. 0. Box 2009, Stockton, CA 9520.1 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />