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RAN JOAQUIN COUNTY PUBLIC' NLTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVAd)N *ew, <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209-468-3420 <br /> INVOICE Account I AR0016370 <br /> Facility I FA0009370 <br /> LMMMMOOMMUMA <br /> Date Printed 4/25/00 <br /> LMMMOMMMMONEEM <br /> GENE WAGNER RE: KUSTOM KURVES AUTO BODY&PAI <br /> KUSTOM KURVES AUTO BODY &PAINT 4 N HOUSTON LN <br /> 4 N HOUSTON LN LODI CA 95240 <br /> LODI CA 9524024 OWNER: GENE WAGNER <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0070117—Date of Invoice: 4/19/00 <br /> 4/19/2000 2220 SM HW GEN<5 TONSNR $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 5/26/2000 <br /> TOTAL DUE this Billing Period $110.00 <br /> Please make Checks PAYABLE to : PHS/EHD / Returns Copy of This STATEMENT with Your PAYMEN <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 earh 30 thereafter <br /> MAY 1020 <br /> SAN JOAQUIN COUN(Y <br /> PUBUC 4FAITH SERVICES <br /> ENVIRONPFEP!?'AI.14EALF"n:41S10t' <br /> 5255.rpt <br />