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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report 15256 <br /> ENVIPONMENTAL- HEALTH DTVI-'ON ste ent Printed : 12 /18/96 <br /> -,04 E WEBER AVENUE - 3RD '�)R <br /> PO BOX 388 <br /> STOCKTON , CA - 95201-0388 <br /> Accounting Office : 209 468-3420 <br /> .N. 11"1 %1' CI .7- C: C3 <br /> i <br /> i <br /> TO : LODI QUICK LUBE <br /> 808 S CHEROKEE LN Account # 0003428 <br /> LORI , CA 95240 . - <br /> ATTN : LODI QUICK LUBE Facility ID 003840 <br /> R�-> _LODL. QUIC-K_L11,B-E4_ <br /> 808 S CHEROKEE LN LODI <br /> I PLEASE RETURN a COPY of TNIS STATEMENT with YOUR PAYMENT <br /> I - <br /> Service Activity <br /> Date Description � Hrs Employee Amount <br /> Invoice # 034579 -- Date of Invoice: 12/17/96 <br /> 12 /17 /96 2380 UST Permit Fee Tank # TA225OO1 $170 . 00 <br /> -----—y-------------------- ------ <br /> Total for this invoice : . ..$170 . 00 <br /> Payment DUE DATE 61 97 <br /> If this INVOICE has been Paid, Please Disregard this Notice . . . <br /> PAYMENT <br /> RyFCF7fVF-Y". <br /> JAN 2 1997 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PENALTIES for all FEES for SERVICE will be ASSESSED <br /> PENALTIES will be ASSESSED on all ANNUAL PERMIT Fe at the rate of lit of the Service Fee <br /> at the rate of 100% of the Base Fee 36 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 : $170 . 00 <br /> ase_ Make_CHECKS PAYABLE <br /> $17O . D� to : F" tl 9 ":cc A IE" 0-011- <br /> p ` $0 00 �$0 0© f m $0 . 00 $0.. 000 <br /> �~-$17© . C10-- <br /> ' 0"to 3_0 days 31 to 60 days 61 to 90 days . 91 to 120 days ) 120 days Account <br /> Balance <br />