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ENVIRONMENTAL HEALTH�OIVIS� � �� �LisvlCe�., <br /> Report 15166 <br /> 304 E WEBER AVENUE -- 3RD F�R Stationt Printed : 05/20/99 <br /> STOCKTON . CA 95202 <br /> Accounting Office : 209 468-3420 <br /> TO : Q—LUBE <br /> 3927 MC HENRY AVE _7—g..-_=-- <br /> MODESTO, CA 95356 Account # 0017067 <br /> ATTN : STUART BURNHAM <br /> Facility ID 010067 <br /> RE : Q—LUBE i <br /> 4715 N WEST LN <br /> STOCKTON <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> Date Description <br /> H r s Employee Amount <br /> Invoice 11 .057210 -- Date of Invoice : 05/18/99 <br /> 05/18/99 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE <br /> __ . $16 . <br /> Total for this invoice : — =18 . 50 i <br /> If this INVOICE hes been Paid, Please Disregard this Notice Payment DUE DAT[ 6/20/99 <br /> I <br /> I*ce # 059402 -- Date of Invoice : 05/18/99 <br /> 18/99 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE <br /> 05/18/99 2220 SM HW GEN <5 TONS/YR . 00 <br /> $100 . <br /> — <br /> Total for this invoice: $110. 00 <br /> If this INVOICE has been Paid, Please Disregard this Notice Payment DUE DATE 0 9 <br /> PAYMENT <br /> f"1111c% Qn93 <br /> ' Penalties will be added on all Perelts JYN° `ASIM FEES penalties will <br /> Puc cekdr.#tue, rate of 111 61 days <br /> at the rate of 111t of the Base Fee 31 ENVApNM1iyCSfll7aCdRte and each 31 days <br /> days after the due data. ALrHR104Pfter <br /> TOTAL DUE this Billing Period : <br /> L128. 50 <br /> Please make Checks PAYABLE to : <br /> PHS JEHD <br /> 1 <br />