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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 /> ,s PORT022 <br /> PORT OF STOCKTON <br /> . PORT OF STOCKTON 2201 W. WASHINGTON <br /> P. 0. BOX 2089 STOCKTON, CA 95203 <br /> STOCKTON, CA 95201 <br /> Billing statement for 1986 Fees Underground Tank Facility. <br /> Statement Date: OCTOREE U. -MI <br /> Due: OCTOBER 31, 1987 <br /> Facility $ <br /> Container # Status <br /> 9 -A 1-�—O-00 <br /> in <br /> State surcharges @ $56 per tank x <br /> � <br /> Subtotal of permit fees: $212..00 r J, <br /> Additional Billings or Credits <br /> 2 <br /> TOTAL FEES DUE: <br /> $$ <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 Health District <br /> 1' Environmental Health Permit/Services P AY MN <br /> P. 0. Box 2009, Stockton, CA 95201 VzVE <br /> NMF�TAL HEA <br /> x�}PotiY S�0"V1cES <br /> i <br />