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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report #5255 <br /> ENVIRONMENTAL HEALTH DIVISION St- `ement Printed : 02/05/96 <br /> 304 E WEBER AVENUE — 3RD BOOR <br /> PO BOX 388 / <br /> STOCKTON , CA 95201-0388 <br /> Accounting Office : 209 468-3420 <br /> ra FFB g 2 00 PH '96 <br /> TO : LODI UNIFIED SCHOOL DIST <br /> <br /> <br /> ATTN : HEALTH PERMITS Facility ID 003842 <br /> RE : LODI USD—TRANSPORATION* <br /> 820 S CLUFF AVE LODI <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> Date Description Hrs Employee Amount <br /> Invoice # 026414 -- Date of Invoice: 02/05/96 <br /> 02/05/96 2301 UST State Surcharge Fee Tank # TA196901 $56 . 00 <br /> 02/05/96 2301 UST State Surcharge Fee Tank # TA196902 $56 . 00 <br /> 02/05/96 2301 UST State Surcharge Fee Tank # TA196903 $56 . 00 <br /> 02/05/96 2301 UST State Surcharge Fee Tank # TA196904 $56 . 00 <br /> ------------------------------------- <br /> Total for this invoice : ✓ $224 .00 <br /> Payment DUE DATE V 03/06/96 <br /> If this INVOICE has been Paid, Please Disregard this Notice . <br /> PAYMENT <br /> ^vrFIVED <br /> MAR 141996 <br /> 311%JOAOUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> .,.:cq,ALHEALTH <br /> 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 loot of the Base Fee 30 days after the Payment DUE DATE <br /> 31 days after the Payment DUE DATE. and EACH 30 days thereafter. <br /> TOTAL DUE this Billing Period: $224 .00 <br /> Account1-30 Days 31-60 Days 61-90Days 91-120 Days 121+ Plus <br /> Summary <br /> 904 . 00 0 . 00 0 . 00 0 . 00 0 . <br />