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L <br /> t. <br /> 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, N.D. , Health Officer <br /> CITY OF TRACY TRACY40 <br /> 560 S. TRACY BLVD. CITY OF TRACY POLICE DEPT. <br /> 400 E. 10th St. <br /> TRACY, CA 95376 <br /> TRACY, CA 95376 <br /> Billing statement for 1996 & 1987 Underground Tank Facility. <br /> Statement Date : MAY 20, 1987 Date Due JUNE 30. 1987 <br /> 1986 1987 <br /> Facility $100.00 Facility $100.00 <br /> Tank N *Status Tank # *Status <br /> 1 A g 50 1 A g 50 <br /> State surcharges @ $56 per tank x I $ 56.00 <br /> Subtotal of permit fees 1986 $ 150.00 <br /> Subtotal of permit fees 1987 $ 150.00 <br /> TOTAL FRES DUE: $ 356.00 <br /> •A - Active <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br /> Notify the San Joaquin Local Health District. of any corrections or changes <br /> necessary . <br /> Return payment along with one 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 />