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OFFICE OF EMERGENCY SERVICES <br /> HAZARDOUS MATERIAL MANAGEMENT PLAN FEE <br /> CURRENT YEAR <br /> /� BILLING CORRECTIION RECORD <br /> n <br /> Name of Businesses ,C�l�ji r.P 0 1� <br /> PrimaryContact �\Y)VON0.1U 1= . f—CLLece:+ Account No. 535 <br /> Facility Mailing Address k ea-7 Ir. , S fo c-OOLA �SZO C7 <br /> Billing Year That Error Was Made 957 <br /> 00 <br /> Amount Originally Invoiced <br /> Original Base Fee/Chemical Cou/2-4©'s t -7 � • <br /> Type of Error: [ ] Data Entry A Re//view [ ] Other / / <br /> Nature of Error �2Y %/I�,OPL1'il, �� /99.4/ 7Yi <br /> / <br /> Ce e /72 If rQo/ ;n <br /> Corrected Base Fee/Chemical County/" 2t/ S2 Gni cpt. <br /> Qo <br /> Amount Overcharged 3© _ <br /> Amounts Undercharged <br /> Comments A)0,0 ,e- <br /> For <br /> For Supervisor's Use: Supervisor's Approval Dlelznz&c <br /> Actions Taken or Ordered /« �nGly G��au�Gr ccGr✓ .2G <br /> y, � -z'; Jv <br />