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SAN JOAQUIN LOeAL 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 /> JJNION41 <br /> UNOCAL .UNION OIL SS# 6071 <br /> 2175 N. CALIFORNIA BLVD. , STE. 650 A170 E. WATERLOO RD. <br /> WALNUT CREEK, CA 94596 STOCKTON, CA 95205 <br /> Billing statement for 1987 Permit <br /> Underground Tank Facility, <br /> Statement Date: March 15, 1987 <br /> Due: April 15, 1987 <br /> .ti <br /> Facility $ 100.00 <br /> Container # *Status <br /> 1 <br /> --�- A g 50.00 <br /> A 0. 0 : a7' <br /> State surcharges @ $56 per tank x 706 <br /> Subtotal of permit fees: $ <br /> Additional Billings or Credits <br /> TOTAL FEES DUE: S 250.00 <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 />