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SAN JUAPAW LOCAL HEALTH DISIRICT <br /> 160t E. 0e l t.on Ave. P.O. circ„ 2009 <br /> Stockton, CA 0201 <br /> (209) 468-3425 <br /> .1ogi Kf`E.inna; M.D. , Health Officer <br /> .- <br /> <br /> STOCKTON, CA 95207 <br /> 611.11 no Statement F!_r 1989 Permit, Underground Tank Facility . <br /> Statement Date i january 1 , 1989 <br /> Payment Due Date i February 1 , 1989 <br /> Facility Fee: 100.00 <br /> Container Number: 0001 so.01f) <br /> TOTAL 's EES DUE $150.00 <br /> NOTES <br /> Notify We San .,fo qui1i Local <br /> mailedHealth District of any <br /> corrections or changes <br /> necessary . Your permit will <br /> be upon! F t . <br /> payment and approval of <br /> facility . <br /> Return payment cEi+ung with one <br /> copy of this Qatement to: <br /> SAN 319r,f,;U l N LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH PERMIT/SERVICES <br /> P.O. BOX 2009I <br /> STOCKTON, CA 96201 <br /> Penalties will be added after <br /> Buie date a, shown, <br /> 30 days - 100 of Fuse Fee <br />