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SAN JOAOUIN COUNTY PUBLI� J%LTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> 209-468-3420 <br /> INVOICE Account 10 AR0016046 <br /> Facility ID FA0009046 <br /> Date Pdnted 1/31/01 <br /> FRANK BROCKMAN RE : CALIFORNIA RADIATOR WORKS <br /> CALIFORNIA RADIATOR WORKS 328 S CALIFORNIA ST <br /> 328 S CALIFORNIA ST STOCKTON CA 952033520 <br /> STOCKTON CA 95203 35 <br /> OWNER: FRANK BROCKMAN <br /> Health <br /> _ t - Date-__-Grogram. Desctipticn __ _ -_- _ - ---. Firs Employee Amount <br /> Invoice# IN0079609---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 3/212001 <br /> TOTAL DUE this Billing Period $1TQ:B0 <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 /> RECEIVED <br /> MAR 0 1 2001 <br /> r,M. <br /> 5255.rpt <br />