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T SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVIS�. <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209-468-3420 <br /> INVOICE Account I AR0016876 <br /> Facility I FA0009876 <br /> Date Printed4/25/00 <br /> BLAINE J DEJONG RE: BLAINE DEJONG'S AUTO WORKS INC <br /> BLAINE DEJONG'S AUTO WORKS INC 324 N CLUFF AVE <br /> 324 N CLUFF AVE LODI CA 95240 <br /> LODI CA 95240 OWNER: BLAINE DEJONG'S AUTO WORKS INC <br /> Health <br /> Date Program Deacrlption Hrs Employee Arnbunt <br /> Invoice# IN0070461 —•Date of Invoice: 4/19/00 <br /> 4/19/2000 2220 SM HW 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 ::;;00) <br /> / 0 <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 be added to all Permit Fees For all SERVICE FEE <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 /> PAYMEN <br /> RECEIVED <br /> MAY 9 ZB <br /> SAN OAQUIN COUNry <br /> Pt <br /> ENVIgjaiJC HEALTH SERVICES <br /> TffAL HEALTH DNISIOI+ <br /> 5255.rpt <br />