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SAN JOAQUIN COUNTY PUBLIC Ac ".TH SERVICES ` Page 1 <br /> ENVIRONMENTAL HEALTH DIVIS?,, , wWO <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209-465-3420 <br /> INVOICE Account) AR0016006 <br /> Facility I FA0009006 <br /> Date Printedq/25/00 <br /> JACK LABERGE RE: BRUCE&JACK AUTOMOTIVE <br /> BRUCE&JACK AUTOMOTIVE 12 E POPLAR ST <br /> <br /> OWNER: JACK LABERGE <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoica!l W0069862---Date of Invoice: e/talon <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 St25/2000 <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%ofthe 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 each 30 thereafter <br /> RECEIVED <br /> MAY 162M <br /> SM JDACA N C(XgM <br /> FLUX SERVICES <br /> ENN�M�ENTATMHEALTH OMSY}H <br /> 5255.rpt <br />