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ISLIC HEALTH -•ERVICE= <br /> =AN JOA(;•tilN COUNTY <br /> .� rl.>!S N . San Joaquin _;+, , P .01 . B,_x 201� [ G <br /> �L` yrj�3 <br /> rs ! ^ n{rs Dept <br /> publ+c`'ttocydoa w <br /> /� Ce0`19cN� ,a <br /> VIPER ULO </ •- � � <br /> NISTOCti:r_, ; <br /> =:it.e ni_,rri,atio := <br /> C;_r=;, 0-P I Pile . WORKS/T . Fi;K !�)t3T0 C i:_,;MUNI ti t I L I T I E' =WEN-=•F,N <br /> <br /> ST C1CP:: "Gini, CA <br /> ,ervi-ces w_,pe -. i`rovl-led for you by the En ironmeiit-1 Health Division on <br /> .'ani.Aa;'y 12. 199:3 f;:•r Ui3' r REMOVAL 1iiJr;; 1217/'±'2, 1?12l`_±:3 <br /> It Voice Date ; JANCiAr'Y IS, OTAL DUE ; 15E, . 00 <br /> 10% Penalty will be added each <br /> _0 days Fastinvoice date . <br /> PLEA_*E REPT RT CHANGE:_. IN THE RETURN PAYNEP•i1' AI i tNG WI Tti LI..r <br /> `=PACE PROVIDED BELOW WITHIN THIS STATEMENT fut <br /> 15 DAYS OF THE DATE OF THIS <br /> T "' i- N T I S � 1 <br /> �N'v?!ICE . IF NOTIFICATION 1J }-'UL`�it_ I"We•nit.!-! St•re,'1(eE,, Li3!, <br /> NOT RECEIVED WITHIN THAT TIME Count.Y/E-nvironeiiental Healt-! <br /> PERIOD, THE PART''i IDENTIFIED P. Ct . Bo-x 2,001, =;t.nrt..tor!, (.a 9S2C,I <br /> ABO4i1 WILL BE LEGALLY RE,:-:,PON- <br /> C-1 -E F'OR THI=: BILL . <br /> IF iHe <br /> ABOVE oILLiNG r1UUit:=S=; I'3 iVi{I" CEiFRE{_T, PLEA, Ihu )I_ iE EELiU,J <br /> NAME 1 i._. <br /> ADDR-E—•_;----------------------- - ------------ ----- --------------------- <br /> ---------------------------- --------- <br /> ;iTY =;TATE _I ' <br /> PAYMENT <br /> RECEIVED <br /> JAN 2 3 1993 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH cEP'�IC"(z <br /> �! ENVIRONMENTAL HEA; fHbivI ',)P: <br />