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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Avenue, P 0 Box 2009 <br /> Stockton , CA 95201 <br /> (209)466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> • DON'S DISTRIBUTING COMPANY DON'S DISTRIBUTING COMPANY <br /> • P.O. BOX 269 1320 W. IJEBER AVENUE <br /> • STOCKTON, CA 95201 STOCKTON, CA 95203 <br /> Billing statement for 1986 - 1987 Underground Tank Facility. <br /> Statement Date: JUNE 2, 1987 Date Due JUNE 30, 1987 <br /> 1986 1987 <br /> Facility $100.00 Facility $100.00 <br /> Tank # *Status Tank # *Status <br /> 1 —1A 50-00 1 _A $_5.0...00 <br /> State surcharges @ $56 per tank x 1 = $ 56.00 <br /> Subtotal of permit fees 1986 $150.00 <br /> Subtotal of permit fees 1987 $150.00 <br /> TOTAL FEES DUE: $ 356.00 <br /> *A - Active <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br /> Notify the San Joaquin Local Health District of any corrections or changes <br /> necessary . <br /> Return payment along with one copy of this statement to: <br /> San Joaquin Local health District <br /> Environemntal Health Permit/Services <br /> P 0 Box 2009, Stockton, CA 9520'PAYMENT <br /> RECEIVED <br /> JUL 2 1987 -7/t <br /> ENVIRONMENTAL HEALTH <br /> PERMITISERVICES <br />