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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> EN ccRONMEoITAL HEALTH DIVISION <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209-468-3420 <br /> INVOICE Account l0 AR0003260 <br /> Facility I FA0003682 <br /> Date Print 4/24/00 <br /> CALIFORNIA HIGHWAY PATROL RE: CALIFORNIA HIGHWAY PATROL#266 <br /> CALIFORNIA HIGHWAY PATROL#266 385 W GRANT LINE RD <br /> - <br /> OWNER: CALIFORNIA HIGHWAY PATROL <br /> Health <br /> Date Program Description Hrs Employee Amount . <br /> Invoice# IN0069503—Date of Invoice: 4119100 <br /> 4119/2000 2220 SM HW GEN<5 TONSNR $100.00 <br /> 4119/2000 2380 Underground Storage Tank EH Operating Permit Fee Tank#001 $170.00 <br /> 4/19/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $260.00 <br /> Payment Due Date 2#29Q0 <br /> — _-- — — --- TOTAL DUE--this F411ingEeriod <br /> Please make Checks PAYABLE to : PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> 266-Tracy <br /> APProved for Payment <br /> Date: _ t'• o —vy�-'"� <br /> Contract#, PO#, Delegation #,X#• JUN 9 2000 <br /> f �y.'OA^ttlN i.O:B. r <br /> Coding: w A C iE uH JC:7.i cS <br /> ENVIRONMENTAL.HEALTH DIVISION <br /> Signature: <br /> Title/ID#: <br /> Date Goods ROCV'd: <br /> 5255.rpt <br />