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.. _ ION ��nvi�[� r0r/ 6o <br /> ENVtRONMENTAI HEALTH DIVISION StaY�ment Printed :: 01 /23(93/96 <br /> OA c WEBER AVENUE — 3RD F OR <br /> PO BOX 388 5(A —w <br /> STOCKTON , CA 95201-0388 <br /> Accounting Office : 209 468-3420 <br /> = nvC� -L <br /> TO : ROSATO & RELF INVESTMENTS <br /> PO BOX 8640 Account # 0003391 <br /> STOCKTON , CA 95208 <br /> ATTN : WILLIAM RELFb� Facility ID 003806 <br /> RE : J H SIMPSON CO <br /> 4025 CORONADO AVE STOCKTON <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> [Date Description Hrs Employee Amount <br /> Invoice # 025727 -- Date of Invoice : 01/22/96 <br /> 01/22/96 2380 UST Permit Fee Tank # TA106801 $ 0 <br /> ----------------------------- ------- <br /> Total for this invoice: $170.00 <br /> 0 /21/9 <br /> If this INVOICE has been Paid, Please Disregard this Notice . Payment DUE DATE <br /> PAYM- <br /> Ul <br /> E!ffJAN <br /> sRec <br /> J. cda" <br /> � <br /> FEB - I POSTED <br /> SAN JOAQ ., JAN 2i 9 1996 s <br /> PUBLIC H&At l <br /> ENVIRONMENTAL r <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 illi of the Base Fee 3/ days after the Payment DUE DATE <br /> 31 days after the Payment DUE DATE. and EACH 31 days thereafter. <br /> TOTAL DUE this Billing Period: $170.00 <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 />