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SAN JOAQU I N LOCAL HEALTH DISTRICT <br /> 1601 C. Hazelton Ave. , P.U. Box 2009 <br /> Stockton, Cts 95201 <br /> (209) 468-3425 <br /> tic^3i Khanna, M.D. , Health Officer <br /> tATER4' <br /> WATERLOO <br /> <br /> ; <br /> STOCKTON, CA 9S205 <br /> Billing Statement. For 1988 Permit, Lirderground Tank Facility , <br /> Statement Date . January 15, 1988 <br /> Payment Due Date: February 15, 088 <br /> Facility Fee; 100.00 <br /> Container Number: 0001 80.00 <br /> £}002 60.00 <br /> 0 <br /> 0003?: 150.00 <br /> 0004 so.00 <br /> TOTAL FEES DUE $300.00 <br /> NOTES <br /> Notify the San Joaquin Local <br /> Health District & any <br /> corrections or changes <br /> necessary. Your permit t wilt , <br /> be mailed upon receipt of <br /> Payment and approval of <br /> facility. <br /> Return payment along with one <br /> Copy of this statement to: <br /> SAN 3CiAQUIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH PERMIT/SERVICES <br /> P.O. BE tX 2009 <br /> STOCKTON, CA 95201 <br /> Penalties will be added after <br /> due date as shown: <br /> 30 clays - 100% of Base Fee <br /> t ' <br />