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SAX JOAQUIN COUNTY PUBLIC HF sLTH SERVICES — Page 1 <br /> ENVIRONMENTAL HEALTH DIVIS,..,4 <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209468-3420 <br /> INVOICE Account I AR0016124 <br /> LMEMMUNUMMMA <br /> Facility la—FA-0 009124 <br /> LMMUMMONOMMOR <br /> Date Printe 5/10/00 <br /> MICHAEL PHELAN RE: GEWEKE FORD MERCURY JEEP EAGL <br /> GEWEKE FORD MERCURY JEEP EAGLE 1045 S CHEROKEE IN <br /> PO BOX 1210 LODI CA 95240 20 <br /> LODI CA 95241 <br /> OWNER: DARYL GEWEKE <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IND069948—Date of Invoice: 4/19/00 <br /> 4/19/2000 2220 SM HIN GEN<5 TONS/YR $100.00 <br /> 4/19/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $110.00 <br /> Payment Due Date 6/9/2000 <br /> TOTAL DUE this Billing Periodl $110.0p <br /> Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYM T <br /> Penalties will be added w-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 /> PA MEN f: <br /> MAY 10M <br /> t AN JOAQUIN UOjk r <br /> PUBLIC HEALTH NORVI0€9 <br /> 80W RONMENTAL H€ALTH DIVISION <br /> 5255.rpt <br />