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' SAN JOAQOIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 466-6181 <br /> Jogi Khanna, H.O.. Health Officer <br /> GLENN PRI.CKE . AMERI27 <br /> . AMERICAN TRANSFER <br /> 2701 S N 99 . 2701 S HWY 99 <br /> STOCKTON, CA 95205 . STOCKTON, CA 95205 <br /> Billing statement for 1981 Permit Underground Tank Facility. <br /> Statement Date: MAY 1 , 1987 <br /> Due: JUNE 1, 1987 <br /> Facility S 100.00 <br /> Container N Status ss <br /> 1 A 30 <br /> "TD — <br /> State surcharges @ $56 per tank x = <br /> Subtotal of permit fees: 1200 <br /> Additional Billings or Credits �1 <br /> Additional 1986 feel <br /> ( 1 tank an surc arge- S 10.6 .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 /> Active P. 0. Box 2009. Stockton. CA 95201 <br /> TC - Temporary Closure <br /> PC - Permanent Closurr <br />