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F� � CAQUIN COUNTY PUB ALTH SERVICES . Report 05255 <br /> _y=YRONMENTAL HEALTH DIVI N Stament Printed : 06/28/99 <br /> 304 E WEBER AVENUE — 3RD FLOOR <br /> STOCKTON , CA 95202 <br /> Accounting Office : 209 468-3420 <br /> TO : JACKPOT FOOD MART* <br /> <br /> <br /> — --_- � <br /> Facility ID 000091 <br /> RE : JACKPOT FOOD MART* <br /> —-- 14000 E HWY 88 <br /> LOCKEFORD <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> Date Description Hrs Employee Amount <br /> Invoice # 058706 -- Date of Invoice: 05/18/99 <br /> 05/18/99 2220 SM HW GEN (5 TONS/YR $100 . 00 <br /> ----- --------------------------'-----. <br /> Total for this invoice : 00. 0 <br /> Payment DUE DATE 06/20/9 <br /> If this INVOICE has been Paid, Please Disregard this Notice <br /> PAYMENT <br /> QE 014WY.. <br /> JUL 1599 <br /> SAN JOAQUIN COUNTY <br /> PUSUC HFALTVII SERVICES <br /> ... ENVIR0NM6NTAL HEALTH DNt51UN <br /> For all SERVICE FEES penalties will <br /> Penalties will be added on all Permits be added at the rate of 10% 60 days <br /> at the rate of 100% of the Base Fee 30 past invoice date and each 30 days <br /> days after the due date. thereafter. <br /> TOTAL DUE this Billing Period : $100 . 00 <br /> Please make Checks PAYABLE to : PHS/EHD <br />