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SAN JOAQUIN COUNTY PUBLIC 14TH SERVICES � Rsport 0?5 <br /> ENVIRONMENTAL HEALTH DIVISION Statement Printed : 01117 /0 ' <br /> 3O4 E WEBER AVENUE — 3RD FLOOR <br /> STOCKTON , CA 95202 <br /> Accounting Office : 209 468-3420 <br /> TO : OMS 124 STATE MILITARY DEPT* <br /> PO BOX 269101 A <br /> ccount 1 000340 <br /> SACRAMENTO , CA 95826 9101 =-- ___..:____�_ _. <br /> ATTN : STATE MILITARY DEPT i Facility 1D 003815 <br /> RE : ONS 424 STATE MILITARY DEPT* <br /> 3010 /8020 S AIRPORT STOCKTON <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> Date Description H r s Employee Amount: I <br /> Invoice # 034562 -- Date of Invoice : 12/17/96 <br /> 12/17 /96 2380 UST Permit Fee Tank # TA1717O2 x17'; . ; •: <br /> 12 /17 /96 2380 UST Permit Fee Tank # TA1717O3 <br /> 01 /18/97 PAYMENT <br /> ----------------------------------- - - <br /> Total for this invoice : $17e . 10 <br /> Payment OUC DATE 01/18/97 <br /> If this INVOICE has been Paid, Please Disregard this Notice . . . <br /> PENALTIES for all FEES for SERVICE will be ASSESSED <br /> PENALTIES will be ASSESSED on all ANNUAL PERMIT Fe at the rate of 10: of the Service Fee <br /> at the rate of 100% of the Base Fee 30 days after the Payment DUE DATE <br /> 30 days after the Payment DUE DATE. and EACH 30 days thereafter. <br /> TOTAL DUE this Billing Period : $170 . 00;' <br /> Please Make CHECKS PAYABLE to : If:" FA to air Ii:a F1 II 1l <br /> $343 . 00 $ 170 00 $0 . 00 $0 . 00 $0 . 00 1173 <br /> 0 to 30 days 31 to 60 days 61 to 93 days 91 to 120 days ) 120 days Account <br /> Balance <br />