Laserfiche WebLink
yr^ <br /> SAN JMIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. . P. 0. Box 2009 <br /> Stockton. CA 95201 <br /> (209) 466-6781 <br /> Jogi Khanna. N.O. . Health Officer <br /> . AMERI27 <br /> GLENN PRICKETT . AMERICAN TRANSFER <br /> 2701 S HWY 99 . 2701 S HWY 99 <br /> STOCKTON, CA 95205 . STOCKTON, CA 95205 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: MAY 1, 1987 <br /> Due: JUNE 1, 1987 <br /> Facility f 100.00 <br /> Container / Status <br /> 1 A50 <br /> 2 —A fr6.�_ <br /> S PAYMENT <br /> _ S RECEIVED <br /> MAY 19 <br /> State surcharges @ $56 per tank x ENVIRONMENTAL HEALTH <br /> PERMITISEKVJCES._ <br /> Subtotal of permit fees: 1200 <br /> Additional Billings or Credits <br /> Additional 1986 fee <br /> ( 1 tank an sure arge S 106 .00 <br /> TOTAL FEES DUE: 5306 .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 /> � r <br />