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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P.O. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 468-3425 <br /> Jo-3-1 Khanna, M.D. , Health Officer <br /> ERNIE44 <br /> ERNIE'S GENERAL STORE ERNiE'S GENERAL STORE <br /> 4407 E. WATERLOO RD. 4407 E. WATERLOO RD. <br /> STOCKTON, CA 95205 STOCKTON, CA '35206 <br /> Billing St.at.ement. For 15:;5 Pei°rnit., Underground Tank Facility. <br /> Statement Date January 15, 1988 <br /> Payment. Due Date: February 15, 1988 <br /> Facility Fee; 10(:.00 <br /> Container Number ; 0001 ;0.0(11 <br /> 0002 1�0.00 <br /> 0003 50.00 <br /> TOTAL FEE'S DUE 625:1.Di? <br /> NOTES; <br /> Notify the San Joaquin Local <br /> Health District. of any <br /> corrections or Changes <br /> necessary . Your permit will <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 /> 5AN JOAQUIN LOCAL. HEAL';H Dl`'c -.T <br /> ENVIRONMENTAL HEALTH PERMIT/SERVICES <br /> P.O. BOX 2009 <br /> STOCKTON, CA 95201. <br /> Penalties wi.11 be added after <br /> due date as shown: <br /> .30 days - 100% of Base Fee <br /> 0 • <br />