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JOAQUIN LOCAL HEALTH DIST 0 <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 /> • CURTI24 <br /> GARY CURTISS CURTISS PONTIAC-CADILLAC-GMC <br /> CURTISS PONTIAC - CADILLAC-GMC 2450 TOSTE RD. <br /> 2450 TOSTE RD. TRACY, CA 95376 <br /> TRACY, CA 95376 <br /> Billing statement for 1987 Underground Tank Facility. <br /> Statement Date: OCTOBER 1, 1987 <br /> Due: OCTOBER 31, 1987 <br /> Facility $ 100.00 <br /> Container # *Status <br /> 1 A $ 5a.o0 PAYMENT <br /> $ RECEIVED <br /> OCT 2 7 1987 <br /> $ <br /> $ ENVIRONMENTAL HEALTH <br /> $ PERMITISERVICES <br /> State surcharges @ $56 per tank x 1 = 56.00 <br /> Subtotal of permit fees: $ 206.00 <br /> Additional Billings or Credits <br /> (Facility fee & tank fee - 1986) $ 150.00 <br /> TOTAL FEES DUE: $ 356.00 <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 /> and approval of facility. <br /> 30 days - 100% of Base Fee 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 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />