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SPOjA^OAQUIN COUNTY PUBLIC HEALTH SERVICES Report #5255 I <br /> T-NVTRIONMENTAL HEALTH OIVISIOfN Statement Printed : 02/05/96 <br /> f0-4'—E WEBENUE - 3RD FLOOR I <br /> PO BOX 384-, <br /> STOCKTON , CA x95201-0388 <br /> Accounting• Offi.ce : 209 468-3420 <br /> I <br /> I I <br /> TO : ROTO ROOTER (' _ <br /> PO BOX 31300 �\ Account # — 0003324 <br /> STOCKTON , CA 95213 <br /> ATTN : ROTO ROOTER Facillty ID— 003745 p <br /> RE : ROTO ROOTER <br /> -E CARPENTER _tTOCIVTON <br /> 3480 <br /> I <br /> j PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> IService Activity <br /> ' ate Description --' Hrs Employee Amount <br /> Dt <br /> = �— -- <br /> I <br /> Invoice # 026360 -- Date of Invoice : 02/05/96 <br /> 02/05/96 2301 UST State Surcharge Fee Tank # TA153301 $56 . 00 <br /> 02/05/96 2301 UST State Surcharge Fee Tank # TA153302 $ 00 <br /> --------------------- ---- <br /> otal for this invoice : $112.00 <br /> Payment DUE DATE 3/06/9 <br /> i <br /> If this INVOICE has been Paid, Please Disregard this Notice . <br /> I <br /> I <br /> i <br /> I <br /> I <br /> I <br /> I <br /> I <br /> PAYMENIY <br /> I <br /> FEB 2 01996 <br /> I <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENT AL HEALTH DIVISION I <br /> I <br /> PENALTIES for all FEES for SERVICE will be ASSESSED <br /> PENALTIES will be ASSESSED on all ANNUAL PERMITS at the rate of ilt orf the Service Fee <br /> at the rate of lift of the Base Fee 31 days after the Payment DUE DATE <br /> 30 days after the Payment DUE DATE, and EACH 30 days thereafter. <br /> TOTAL DUE this Billing Period: $112 .00 <br /> Account 1-30 Da s 31-60 Da s 61-90 Da s 91-120 Da s 121+ Plus <br /> I ' <br /> Summary <br /> 112 . 00 -135 . 00 0 . 00 0 . 00 0 . 00 <br />