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nAN JOAQUIN COUNTY PUBLIC H TH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISI 4 Report #5255 <br /> 445 N SAN JOAQUIN <br /> PO BOX 2009 <br /> STOCKTON, CA 95201 209-468-0340 <br /> "c c o to Tti i:' E3-t t e m e n t <br /> TO: KEARNEY - KPF Account # Date <br /> P'0 BOX 8485 0004273 <br /> STOCKTON, CA 95208 <br /> ATTN: FRED PELOT <br /> Facility ID <br /> IRE: KEARNEY - KPF _ <br /> 1624 E ALPINE AV STOCKTON OO4ca2 <br /> PLEASE RETURN THIS STATEMENT WITH YOUR PAYMENT <br /> f— — <br /> Health <br /> Date Program Description o�9• D <br /> �o Amaunt <br /> Previous Balance -- ---_------ <br /> Invoice #004554 -- Date of Invoice: 09/28/93 0. 00 <br /> 08/23/93 5315 REPORT REVIEW <br /> 08/31/93 5310 FIELD CONSULT 78. 00 <br /> 09/16/93 S315 REPORT REVIEW 156. 00 <br /> 12/06/93 9999 PAYMENT 109. 20 <br /> 12/06/93 9999 PAYMENT `109. 20 <br /> 12/06/93 9999 PAYMENT CU� -156. 00 <br /> 01/13/94 5315 REPORT REVIEW "' -78. 00 <br /> 03/08/94 5312 CONSULTATION ` 117. 00 <br /> 03/10/94 5315 REPORT REVIEW tJ';l c I CA� 7800 <br /> 03/15/94 5310 FIELD CONSULT 117. 00 <br /> 0;;/16/94 5310 FIELD CONSULT \`i 156' 00 <br /> 03/17/94 S31O FIELD CONSULT < 1. 18. OO <br /> 03/21/9 + 5310 FIELD CONSULT 4` �\ �' 156" 00 <br /> 0.3/24/94 S31O FIELD CONSULT '- t5} 156. 00 <br /> 03/25/94 5310 FIELD CONSULT 78. 00 <br /> 156. 00�, <br /> Total for this invoice : 11092.00 <br /> PENALTIES on all P=ERMITS FEES will be assessed at the rate of l00% <br /> of the Rase Fee amount 60 days after the INVOICE DATE <br /> 1- 30 Days 31-60 Days 61--90 Da s 91--120 Da 12 + Plus Amount Due <br /> 1, 092. 00 -- ....... — <br /> 0. 00 0. 00 0. 00 0. 00 $ 1, 092. 00 <br /> PENALTIES for all SERVICE FEE billing will be assessed at the rate of <br /> 1O% of the unpaid Invoice Balance 60 days after' the INVOICE DATE and <br /> each 30 days thereafter <br />