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PUBf HEALTH SE"ICES �(? �o <br /> SAN JOAQUIN COUNTY =` <br /> N: < <br /> JOGI KHANNA MD.,M.P.H. <br /> Health Officer <br /> P.O. Box 2009 • (1601 East Hazelton Avenue) • Stockton, California 95201 F o a <br /> (209) 468-3400 <br /> Exxon USA <br /> 4550 Dacoma Third Floor <br /> Houston, TX. 77092 <br /> REGAL64 BILLING STATEMENT <br /> FOR <br /> UNDERGROUND STORAGE TANKS <br /> RE: 6425 PACIFIC AVE. , STOCKTON, CALIFORNIA. <br /> BILLING FOR PERMIT TO OWN AND OPERATE AN UNDERGROUND TANK SITE: <br /> 1989-1991 <br /> STATEMENT DATE: May 6, 1991 <br /> DUE DATE: June 6, 1991 <br /> 1989 1990 1991 <br /> FACILITY FEE: $100. 00 100. 00 N/A <br /> CONTAINER FEES <br /> TANK # 0004 $ PAID 50. 00 170. 00 <br /> 0005 PAID 50. 00 170. 00 <br /> 0006 PAID 50. 00 170. 00 <br /> STATE SURCHARGE <br /> FEE: 0004 $N/A <br /> 0005 N/A <br /> 0006 N/A <br /> AMOUNT DUE: $ 860. 00 <br /> Penalties will be added after <br /> due date as shown: <br /> 30 days - 100% of Base Fee: <br /> NOTES: <br /> Notify Public Health Services, <br /> San Joaquin County of any <br /> corrections or changes. Your <br /> permit will be mailed upon <br /> receipt of payment and <br /> approval of facility. <br /> Return payment along with one <br /> copy of this statement to: <br /> Public Health Services - <br /> Environmental Health Division <br /> P.O. Box 2009 <br /> Stockton, CA. 95201 ugst.fil <br /> (209) 468-3427 <br /> A Division of San Joaquin County Health Care Services � <br />