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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVIS' <br /> 304 E WEBER AVE-3RD FLOOR U <br /> STOCKTON, CA 95202 <br /> 209.468-3420 <br /> INVOICE Account) AR0017511 <br /> Facility I FA0010511 <br /> Date Printed 4/25/00 <br /> DERREL HOUDASHELT RE: UNIVERSITY OF THE PACIFIC-PHAR <br /> UNIVERSITY OF THE PACIFIC-PHARMA 751 W BROOKSIDE RD <br /> 3601 PACIFIC AVE STOCKTON CA 95204 <br /> STOCKTON CA 95204 OWNER: UNIVERSITY OF PACIFIC <br /> Health <br /> Date Pmoram Description Hrs Employee Amount <br /> Invoice# IN0070969--Date of Invoice: 4/19100 <br /> 4/1912000 2220 SM HW GEN<5 TONSNR $100.00 <br /> 4/19/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $110.00 <br /> P.r,ment Due Date 51 <br /> TOTAL DUE this Billing Period 110.00 <br /> Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will added to I Permit Fees Fora all SERVICE FEES <br /> at lite Rate of aam 3 to a! 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 /> P pm: ,L Ori' - <br /> R£L'v4eU <br /> jmpj 1120 <br /> S1rOJN" ._ <br /> Pt O�IKJ F�41 Hr,BrYa1C1Rb�..K• <br /> ENVIRONMF�f`N',r�T <br /> 5255.rpt <br />