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N JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report 15255 <br />,00erxVIRONMENTAL HEALTH DIVISION Statement Printed : 01/29/99 <br /> 304 E WEBER AVENUE — 3RD FLOOR <br /> STOCKTON , CA 95202 <br /> Accounting Office : 209 468-3420 <br /> TO : RO—TILE <br /> <br /> <br /> ATTN : CARY & TERRI HALL Facility ID 003945 <br /> RE : RO—TILE <br /> 310 CLUFF AVE <br /> LODI <br /> PLEASE RETURN a COPY of THIS STATEMENT wit'fi-nH PAYMENT <br /> Service Activity <br /> Date Description Hrs Employee Amount <br /> Invoice # 054227 -- Date of Invoice: 01/28/99 <br /> 01/28/99 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10 . 00 <br /> 01/28 /99 2380 UST Permit Fee Tank # TA259201 $170 . 00 <br /> 01/28/99 2301 UST State Surcharge Fee Tank # PR507735 $8 . 00 <br /> -------------------------------------- <br /> Total for this invoice : $188.00 <br /> Payment DUE DATE 03/01/99 <br /> If this INVOICE has been Paid, Please Disregard this Notice <br /> tj S <br /> lZ <br /> V � D � <br /> D <br /> For all SERVICE FEES penalties will <br /> Penalties will be added on all Pereits be added at the rate of lit 61 days <br /> at the rate of lift of the Base Fee 31 past invoice date and each 31 days <br /> days after the due data. thereafter. <br /> L DUE this Billing Period: $188 .00 <br /> r /9 <br /> Please make9 <br /> Checks PAYABLE to: PHS/EHD <br /> S� 0 IT? Los <br /> FEB 91999 <br /> Q ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br />