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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 1601 E . HAZELTON AVE. . <br /> P 0 PDX 2009, STOCKTON, CA 95201 <br /> PILL FOR SERVICES RENDERED <br /> TIME MINIMUM FOR EACH INSPECTION-1 HOUR. ADDITIONAL INSPECTION TIME <br /> WILT. £+E COMPUTED TO NEAREST <br /> 112 HOUR INCLUDING TRAVEL -TIME. <br /> NOTE : PRIOR TO ALL INSPECTIONS, CONTRACTORS ARE REQUIRED TO GIVE NOTICE <br /> AS SPECIFIED ON THE PERMIT APPLICATION. <br /> SITUS ADDRESS:—z L C�nevoKet ��^ Lac1` PERMIT # & + +r <br /> PILL TO: NAME <br /> ADDRESS -z,to A/Lar,, <br /> i <br /> CITY/STATE ^�'r` ZIP- <br /> PROGRAM: <br /> IPPROGRAM: <br /> DESCRIPTION OF SERVICE(S) : <br /> k'ou� SANITARIAN <br /> DATE TOTAL WEEKDAYS WEE IGHTS WEEKENDS/HOLIDAYS <br /> OF SAM-4:3GPM 4: OPM-SAM <br /> SERVICE HRS WORKED $35/HR 52.50/HR $70/HR <br /> tit <br /> F <br /> f Z l S l k T *�S."o J <br /> DALANCE DUE : r� S�w <br /> PILLING DATE <br /> _- PAYMENT 15 TO BE RECEIVED WITHIN <br /> :'.() DAYS FROM THE BILLING DATE . <br /> RETURN ONE COPY OF THIS BILL ALONG WITH PAYMENT , MAKE CHECKS PAYABLE <br /> TO: SAN. J oA_QU I N LOCAL HEALTH D_I S1'R I CT . <br /> i <br /> Ell 00 43 <br />