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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 /> . HAYRE12 <br /> . HAYRE ' S EGG PRODUCERS HAYRE ' S EGG PRODUCERS <br /> 12565 S MANTHEY RD. . 12565 S MANTHEY RD. <br /> LATHROP , CA 95330 LATHROP , CA 95330 <br /> Billing statement for 1987 Permit underground Tank Facility. <br /> Statement Date: March 15, 1987 , <br /> Due: April 15, 19$7 <br /> Facility $ 100 <br /> Container # *Status <br /> 1 - S 50 <br /> � <br /> 2 A $ 5") - <br /> A ) <br /> 4 A $ 50- <br /> PAYMENT <br /> RECEIVED <br /> State surcharges @ $56 per tank x - $ , !F APR 16 198r <br /> Subtotal of permit fees: $ 3DO iNVIRQNMENTAL HEALTH <br /> Additional Billings or Credits PERMIT/SERVICES <br /> $ <br /> TOTAL FEES DUE: $ 300.00 <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> after 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 P. 0. Box 2009, Stockton, CA 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />