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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 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 a Status <br /> 1 A S 50,00 <br /> 2 A S 50.00 PAYMENT <br /> 3 A 50.00 RECEIVED <br /> JUN 4 1987 <br /> --- �— .ENVIRONMENTAL HEALTH <br /> State surcharges @ SS6 per tank x = PERMIT/SERVICES <br /> Subtotal of permit fees : S 250.0 <br /> Additional Billings or Credits <br /> -TOTAL FEES DUE: 5Z50.00 <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 [lase Fee 1Zetut-n paywnt along with one copy of this <br /> SLatement to: <br /> San Joaquin Local Health District <br /> Environmental liealth Permit/Services <br /> A Active <br /> P. 0. Box 2009. Stockton, CA 95201 <br /> - <br /> TC lenwo vary CloSurc <br /> 1 <br />