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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report #5255 <br /> Ei1VfRLNMENTAL HEALTH DIVIS N Sta dent Printed : 02 /05/96 <br /> 304 E WEBER AVENUE — 3RD F'�eOR <br /> PO BOX 388 <br /> STOCKTON , CA 95201-0388 <br /> Accounting Office : 209 468-3420 <br /> 3r. v Cr x.. c: e: <br /> TO : LODI QUICK LUBE — <br /> 808 S CHEROKEE LN Account # 0003428 <br /> LODI , CA 95240 <br /> ATTN : LODI QUICK LUBE Facility ID 003840 <br /> RE : LODI QUICK LUBE <br /> 808 S CHEROKEE LN LODI <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> Date Description Hrs Employee Amount <br /> Invoice # 026413 -- Date of Invoice : 02/05/96 <br /> 02/05/96 2301 UST State Surcharge Fee Tank # TA225001 $56 . 00 <br /> -------------------------------- <br /> Total for this invoice : ;56.00 <br /> Payment DUE DATE 0 <br /> If this INVOICE has been Paid, Please Disregard this Notice . , . <br /> PAYMENT <br /> - -- - FEB 2 3 1996 <br /> SAN JOAQUIN COU:"il Y <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 PERMITS at the rate of Ilt of the Service Fee <br /> at the rate of 110E of the Base Fee 31 days after the Payment DUE DATE <br /> 30 days after the Payment DUE DATE. and EACH 31 days thereafter. <br /> TOTAL DUE this Billing Period : $56 .00 <br /> Account 1-30 Days 31-60 Days 61-90 Days 91-120 Days 121+ Plus <br /> Summary <br /> 226 . 00 0 . 00 0 . 00 0 . 00 0 . 00 <br />