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. , 0 <br /> j. <br /> 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 /> MOKEL23 <br /> •EAST BAY MUNICIPAL UTILITIES DISTRICT. MOKELUMNE RIVER FISH HATCHERY <br /> P. 0. BOX 158 -- 23024 N. MC INTIRE RD. <br /> CLEMENTS, CA 95227 CLEMENTS, CA 95227 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: March 15, 1987 <br /> Due: April 15, 1987 <br /> Facility $ 100.00 <br /> Container # *Status <br /> 1 A $ 50.00 <br /> State surcharges @ $56 per tank x _ _ $ <br /> Subtotal of permit fees: $ 150.00 <br /> Additional Billings or Credits <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 /> P. 0. Box 2009, Stockton, CA 95201 <br /> A - Active <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />