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..w <br /> 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 /> Sanitary City Disposal Co. ' SANITI3 <br /> P. 0. Box 319 ' SANITARY CITY DISPOSAL CO. <br /> Lodi , CA 95240 ' 1333 E. TURNER RD. <br /> ' LODI, CA 95240 <br /> Billing statement for 1987_ P�_ Underground Tank Facility. <br /> Statement Date: March 15, 1987 <br /> Due: April 15 1987 <br /> Facility $ 100.00 <br /> Container M *Status <br /> 1_ A �50.00 <br /> Z A g 50.00 <br /> PAYMENT <br /> — �— RECEIVED <br /> APR 16 1987 <br /> State surcharges @ $56 per tank x _ _ ENVIRONMENTAL HEALTH <br /> Subtotal of permit fees: $200.00 PERMIT/SERVICES <br /> Additional Billings or Credits <br /> TOTAL FEES DUE: $ 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 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />