Laserfiche WebLink
• 6 • * <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 /> JACKS41 <br /> . JACKSON BUICK - PONTIAC, INC. JACKSON BUICK - PONTIAC, INC. <br /> P.O. BOX 1688 P.O. BOX 1688 <br /> STOCKTON, CA 95202 STOCKTON, CA 95202 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: MAY 1, 1987 <br /> Due: JUNE 1, 1987 <br /> Facility $ 100.00 <br /> Container q Status <br /> —L - $ 50.00 PAYMENT <br /> RECEIVED <br /> AUG 2 6 1987 <br /> ENVIPOMMi SERVCES <br /> LI HEALTH <br /> State surcharges @ $56 per tank x = <br /> Subtotal of permit fees: $ 150.00 <br /> Additional Billings or Credits <br /> Credit for 1986 $ -90.00 <br /> TOTAL FEES DUE : $ 60.00 <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 P. 0. Box 2009, Stockton, CA 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />