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SAN JOAOUIN COUNTY PUBLIC ALTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DMSION ../ <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> 209468-3420 <br /> INVOICE Account ID IAR0017376 <br /> Immmmmmmona <br /> FA0010376 <br /> Facility ID <br /> Date Printed 2/1/01 <br /> LOMMEEMMMMOMM <br /> RALPH MC COOK RE : RANSOM PAINTING CO INC <br /> RANSOM PAINTING CO INC 606 S ANTEROS AVE <br /> PO BOX 1282 STOCKTON CA 95205 20 <br /> STOCKTON CA 95201 <br /> OWNER: TOMS RANSOM <br /> Health <br /> Date Program Description - - --- - Hm Employee Amount <br /> Invoice# IN0080621—Date of Invoice: 1/30/01 <br /> 1/30/2001 2220 SM HW GEN<5 TONSNR $100.00 <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Totalfor this Invoice $110.00 <br /> Payment Due Date 1 <br /> TOTAL DUE this Billing Period $710.00 <br /> Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> PAYMENT <br /> P`C E 1 V E D <br /> FEB 1 2 2001 <br /> ry <br /> 5255.rpt <br />