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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 /> • BJJCO24 <br /> 'B.J.J. COMPANY • B.J.J. COMPANY <br /> P. 0. BOX 30010 • 2431 E . MARIPOSA RD. <br /> STOCKTON, CA 95213 • STOCKTON, CA 95205 <br /> Billing statement for 1987 Underground Tank Facility. <br /> Statement Date: JULY 21, 1987 <br /> Due: AUGUST 21 , 1987 <br /> Facility $ 100.0 <br /> Container H Status <br /> 1 I- $ 50.Op <br /> A 50.00 <br /> $ PAYMENT <br /> RECEIVED j <br /> _ $ SEP 2 5 1957 <br /> State surcharges @ $56 per tank x = .ENVIRONMENTAL HEALTH <br /> �-- PERMIT/SERVICES <br /> Subtotal of permit fees: $ 200.00 <br /> Additional Billings or Credits <br /> TOTAL FEES DUE: $200.00 <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 /> P. 0. Box 2009, Stockton, CA 95201 <br /> \/ `/ <br />