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PUBLIC HEALTH °l' CES, SAN JOWIN COUNTY �.rd <br /> 1601 E. Haz24ebn Ave., P.O. Box 20(r3 <br /> Stockton, CA 95201 <br /> (209) 495-3425 <br /> Jogi Kham, N.O., Health Officer <br /> tWHEIO <br /> <br /> <br /> LOOT, CA '35240 <br /> Billing Statement For 1`K-K) Perrvit, Underground Tank Facility. <br /> Statement Date , January 2, 1990 <br /> Payment Due Date: February 2, !990 <br /> Facility Fee: i(YI).W, <br /> Container Number: uO01 50.00 <br /> K*2 <br /> TOTAL FEES 0,11E s20v 00 <br /> NOTESo <br /> Notify Public Health Services, <br /> San Joaquin County of any <br /> corrections or changes <br /> necessary. Your permiiwill <br /> be mailed upon receipt of <br /> payment and approval of <br /> facility. <br /> Return payment along with one <br /> copy of this statement to, <br /> PUDIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH PERMiTfSER'ViCES <br /> P.O. BOX 2009 <br /> STOCKTON, CA 95201 <br /> Penalties will t¢ added after <br /> clue date as shown.: <br /> 30 days - 100% of Base Fee <br />