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JJAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES ' �eport #5255 <br /> ENVIRONMENTAL HEALTH DIVT ON <br /> 4}45 -N SAN JOAQUIN STREET L <br /> PO BOX 388 <br /> STOCKTON . CA 95201-0388 I <br /> Accounting Office : 209 46.8-0340 <br /> 1 <br /> I r cs c:: cr i.a rt 17 R'._"ce Fri ss ti t:. <br /> i <br /> I <br /> TO : <br /> <br /> � _ <br /> I — — <br /> ATTN : HEALTH PERMITS <br /> Facility ID 00382 <br /> RE : LODI USD-UNIFIED TRANSPORATION Billing Date : 01 (11/95 <br /> 620 S. CLUFF AVE LODI - - - " <br /> PLEASE RETURN THIS STATEOT WITH YOUR PAYMENT <br /> Service Activity <br /> Date Description Hrs Employee Amount <br /> Invoice # 017058 -- Date of Invoice : 01/11/95 PAYMENT <br /> 01/11/95 238.0 Underground Tank Permit Fee 19r. 901 RECEIVED $170 . 00 <br /> 01/11 /95 2380 Undergrdod,;Ta:�k�Permit Fee DZ FEB 19 $170 . 00 <br /> 01 /11 (95 2380 UndergAdnd Tank Permit Fee 03 �AQUINCG�INTY§ANJ $170 . 00 <br /> 01/1%yg 2380 Underground Tank Permit Fee o`�puANJ $170 . 00 <br /> k�FAjI4 SERVICES <br /> -------ENV*a4 EN'Tk-HtAtT tDIVVON---------- <br /> Total for this invoice . 660 .00 <br /> If thia,4NVOICE has been Paid , Please Disregard this Notice . . . <br /> and DEDUCT the Amount Paid from the TOTAL D.UE <br /> I <br /> I <br /> I <br /> Penalties will be added on all PERMIT FEES <br /> at the rate of 100% of the Base Fee <br /> 60 days after the invoice date . <br /> For all SERVICE FEES penalties will 1 <br /> I <br /> I <br /> be added at the rate of 10% <br /> 60 days past the invoice date and 1 <br /> each 30 days thereafter . <br /> TOTAL DUE th L{e ;11ing Period: ::�j680.00 <br /> 41 ly r I <br /> I <br /> Account 1 30 Days ' 31-60 Days 61- 91 120 Days 121+ Plus <br /> Summary <br /> 680 . 00 0 . 00 0 . 00 0 . 00 0 . 00 <br />