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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 /> MCCORI2 <br /> MCCORMICK AND BAXTER CREOSOTING MCCORMICK AND BAXTER CREOSOTINI <br /> P . 0. Box 1723 1214 W . WASHINGTON <br /> STOCKTON, CA 95201 STOCKTON , CA 95203 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: May 8. 1987 <br /> Due: June 8 . 1987 <br /> Facility $ 100 <br /> Container d Status <br /> 1 A 50 <br /> 2 7- $ 50 <br /> 3 50 PAYMENT <br /> $ RECEIVED <br /> JUN 1 ,�I 1367 <br /> ENVIRONMENTAL HEALTH <br /> PERMITISERVICES <br /> Subtotal of permit fees: <br /> Additional Billings or Credits <br /> credit from 1986 S -90 <br /> TOTAL FEES DUE : 5160 . 00 <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> after 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 Ilealih District <br /> Environmental Health Permit/Services <br /> A - Active P. 0. Box 2009 , StoC�, tnn , CA 95701 <br /> T( - Temporary Clo;urr <br />