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DMIY JUMWUln1 I.UUHIT YUDLIU HCMLIH DLKVlLCJ nwpvl � v.+ <br /> ENVIRDNMENTAL HEALTH DIVISION Stat hent Printed : 01/23/96 <br /> 304 � WEBER AVENUE — 3RD F�JR, L.! <br /> PO BOX 388 <br /> STOCKTON, CA 95201-0388 <br /> Accounting Office : 209 468-3420 <br /> TO : LODI QUICK LUBE <br /> 808 S CHEROKEE LN Account # 0003428 <br /> LODI . CA 95240 <br /> ATTN : LODI QUICK LUBE Facility Ip 003840 <br /> RE : LODI QUICK LUBE <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> Date Description Hrs Employee Amount <br /> Invoice * 025752 -- Date of Invoice : 01/22/96 <br /> 01/22/96 2380 UST Permit Fee Tank # TA225001 $170 . 00 <br /> ----- -- ---- -------- <br /> — / — <br /> Total—for—this—invoice :------ <br /> —170.00 <br /> Payment DUE DATE 02/2;21 <br /> If this INVOICE has been Paid, Please Disregard this Notice . . . <br /> PAYMENT <br /> RECEIVED <br /> - - FEB 2 31996 <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 PERMITS at the rate of lit of the Service Fee <br /> at the rate of 101% of the Base Fee 30 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: j170.00 <br /> Account 1-30 Days 31-60 Days 61-90 Days 91-120 Days 121+ Plus <br /> Summary <br /> 170 . 00 0 . 00 0 . 00 0 . 00 0 . 00 <br />