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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 /> •TRIPLE S TRUCK & TRAILER REPAIR 'TRIPL48 <br /> `TRIPLE S TRUCK & TRAILER REPAIR <br /> 4800 WATERLOO RD. '4800 WATERLOO RD. <br /> STOCKTON, CA 95205 'STOCKTON, CA 95205 <br /> Billing statement for 1987 Permit , Underground Tank Facility. <br /> Statement Date: March 15, 1987 <br /> Due: AQril 15, 1987 <br /> Facility $ 100.00 <br /> Container # *Status <br /> 1 A 50.00 <br /> -- PAYMENT <br /> -- $ RECEIVED <br /> -- $ MAY 4 1987 <br /> State surcharges @ $56 per tank x _ _ $ ENVIRONMENTAL <br /> PERMIT HEALTH <br /> Subtotal of permit fees: $ 150.0p /SERVICES <br /> Additional Billings or Credits <br /> S <br /> TOTAL FEES DUE: $ 150.00 <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 /> 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 /> * Environmental Health Permit/Services <br /> A - Active <br /> P. 0. Sox 2009, Stockton, CA 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />