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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Avenue, P 0 Box 2009 <br /> Stockton , CA 95201 <br /> (209)466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> • CLARENCE SMIT BODYSI4 <br /> • CITY ADMINISTRATOR THE BODY SHOP <br /> • CITY OF RIPON 140 S. WALNUT STREET <br /> • 311 W. FIRST STREET RIPON, CA 95366 <br /> RIPON, CA 95366 <br /> Billing statement for 1986 - 1987 Underground Tank Facility . <br /> Statement Date: 111NF 3, 1987 Date Due JUNE 30 1987 <br /> 1986 1987 <br /> Facility $100.00 Facility $100.00 <br /> Tank # *Status Tank # *Status <br /> I _ A $ 50.Q0 _1 A $ 50.00 <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 FEES 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 /> Environemntal Health Permit/Services <br /> P 0 Box 2009, Stockton, CA 95201 <br />