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nayvic +c++ <br /> N J0 QUIN COUNTY PUJ�LVC HEALTH SERVICES Stas�nt Printed : 12 /18/96 <br /> EN LR MENTAL HEALTH OI-VIS` � I , <br /> !`3e�JEBER AVENUE — 3RD FhroRf <br />! P5 BOX .388 r <br /> STOCKTON , CA 952©LX0388 <br /> Accduntng Officer'*4209 468-3420 + ' <br /> J.. <br /> T0 : INDY ELECTRONICS <br /> PO 80X 2301 Account 001180 <br /> MANTECA , CA 95336 <br /> ATTN : INDY ELECTRONIC" Facility TO 001182 <br /> - RE : ITM-Y ELECTRt7NI-CS - <br /> 400 INDUSTRIAL PARK OR MANTECA <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT — <br /> Service Activity I <br /> Date Description HrWL Employee Amount <br /> Invoice # 032962 -- Date of Invoice : 11/04/96 ----------$169 00 <br /> 11/04 /96 2227 GEN 5(25 TONS PERMIT <br /> Total for this invoice : $169 . 00 <br /> Payment DUE DATE 12/05/96 <br /> If this INVOICE has been Paid, Please Disregard this Notice . . . <br /> PAYMENT <br /> JAN 2 21997 <br /> SAN JOAQUIN cOJiNT'! <br /> PUBLIC HEALTH$ERVICEs <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PENALTIES for all FEES for SERVICE will be ASSESSED <br /> PENALTIES will be ASSESSED on all ANNUAL PERMIT Fe at the rate of lot of the Service Fee <br /> at the rate of 100% of the Base Fee 36 days after the Payment DUE DATE <br /> 36 days after the Payment DUE DATE. and EACH 36 days thereafter. <br /> TOTAL DUE this Billing Period : —� $169 . 00 <br /> Please Make CHECKS PAYABLE to : p AA .TE; 1.:;: 1-1 A'b <br /> $0 . 00 $169 . 00 $0 . 00 $0 . 00 $0 . 00 $169 . 00 <br /> 0 to 30-days 31 to 60 days 61 to 91 days 91 to 121 days ) 120 days Account <br /> Balance <br /> t. <br />