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,.` SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> y 1601 E. Hazelton Ave. , P. 0. Box 2009 <br /> Stockton. CA 95201 <br /> (209) 466-6781 <br /> Jogi Khanna. M.O. . Health Officer <br /> PACIF61 <br /> PACIFIC SHELL <br /> - PACIFIC SHELL 6131 PACIFIC AVENUE <br /> 6131 PACIFIC AVENUE STOCKTON, CA 95207 <br /> STOCKTON, CA 95207 <br /> Billing statement for 1981 Permit Underground Tank Facility. <br /> 'Statement Date: MAY 15, 1987 <br /> Due: JUNE 15, 1987 <br /> Facility S 100.00 <br /> Container N Status <br /> 1 A 50 0 <br /> 2 A S 50.00 <br /> 3 A 50.00 <br /> State surcharges @ S56 per tank x _ _ S <br /> Subtotal of permit fees: S 50-0 <br /> Additional Billings or Credits <br /> -TOTAL FEES DUE: SZ59.00 <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 - 1001 of Base Fee Return payment along with one coi)y of this <br /> statement to: <br /> San Joaquin Local Health District <br /> Environmental Health Permit/Services <br /> P. 0. Box 2009, Stockton, CA 95201 <br /> A - Active <br /> TC - Temoorary Closure <br /> IT - Perfn.inen1 0wurf. <br />