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0 • <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Avenue , P O Box 2009 <br /> Stockton , CA 95201 <br /> (209)466-6781 <br /> Jogi Khanna, M.D. , Health Officer <br /> . ESCALON TIRE SUPPLY <br /> . 1910 MAIN STREET ESCALON TIRE SUPPLY <br /> . ESCALON, CA 95320 1910 MAIN STREET <br /> ESCALON, CA 95320 <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 /> I A 4 50.00 1 A S 50.00 <br /> 2 A 5b.00 5— --C- —300 <br /> State—sur tsar-ges @ $56 per tank x 2_ $ 112.00 <br /> Subtotal of permit fees 1986 $ 200.00 <br /> Subtotal of permit fees 1987 $ 200.00 <br /> TOTAL FEES DUE: $ 512.00 <br /> *A - Active <br /> TC - 'remporary Closure <br /> PC - Permanent Closure <br /> Notify the San Joaquin Local Health District of any corrections- or changes <br /> ne-ces:;ary- <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 95201 <br /> is 0 <br />