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,Q CN J6AOUIN COUNTY PUBLIC HEALTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCICTON. CA 95202 <br /> 20946&3420 <br /> INVOICE Account) AR0017935 <br /> FaSility I FA0010935 <br /> Date Printe 5/30/00 <br /> <br /> <br /> <br /> OWNER: JOSE LUIS LOPEZ <br /> Health <br /> pate Program Description Hrs Employee Amount <br /> Invoice# IN0071322--Date of Invoice: 4/19/00 <br /> 64'OT�CE <br /> 4/19/2000 2220 SM HW GEN<5 TONS/YR $100.00 <br /> 4/19/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> To for lhls Invoice $110.00 <br /> Payment Due Date 6129 <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 Dam 60 Days after the Invoice Date and each 30 thereafter <br /> PAYMENT <br /> RECEIVED <br /> JUN 2 6 2000 <br /> PAN JOAON COUNTY <br /> UBLICO HEEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 57.55 m1 <br />