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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.D. , Health Officer <br /> ' PACIF34 <br /> PACIFIC BELL ' PACIFIC BELL <br /> 44 W. YOKUTS, ROOM 100 ' 345 N. SAN JOAQUIN <br /> STOCKTON, CA 95207 * STOCKTON, CA 95202 <br /> Billing statement for 1987 Permit Underground Tank Facility. <br /> Statement Date: AUGUST 10, 1987 <br /> Due: SEPTEMBER 10, 1987 <br /> Facility 100 <br /> Container N *Status <br /> 1 A $ 50 <br /> —3— 9_._ $ 50 <br /> . 4 A— Sn <br /> 5 _ .6. 0 <br /> Subtotal of permit fees: $ 350.00 <br /> Additional Billings or Credits <br /> S <br /> TOTAL FEES DUE: $350.00 <br /> Penalties will be added Notify the San Joaquin Local Health District <br /> after 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 Base Fee Return payment along with one copy of this <br /> statement to: <br /> San Joaquin Local Health District <br /> Environmental Health Permit/Services <br /> A Active <br /> P. 0. Box 2009, Stockton, CA 95201 <br /> - <br /> TC - Temporary Closure <br /> PC - Permanent Closure <br />