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SAKJOAQUIN COUNTY PUBLIC HE�TH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVISI <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 r <br /> 209-468-3420 /► <br /> INV©ICE Account) AR0016616 <br /> Facility ID FA0009618 <br /> Date Printed 4/25/00 <br /> MARK DILLOW RE: FOOD EXPRESS INC <br /> FOOD EXPRESS INC 1250 E MADRUGA RD <br /> <br /> <br /> OWNER: WALTER KEENEY <br /> Health <br /> Date Pregra... Description Hrs Employee Amount <br /> Invoice# IN0070257—Date of Invoice: 4119100 <br /> 4/19/2000 2220 SM HW GEN<5 TONSNR �' $100.00 <br /> 4/19/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.0 <br /> Total for this Invoice !Eo) <br /> Payment Due Date Sl2 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 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 eadt 30 thereafter <br /> r � . <br /> PAYMEW <br /> RECEIVEC <br /> MAY 5 2000 <br /> SAN JOAQUIN COUNTY' <br /> PUSUC HEALTH SETner):� <br /> Fnt,,,r."NMEI4YA1.M1'F,dLY1'i''.a�sfdia <br /> 5255.rpt <br />