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�1 14 ,�JLInIIU.�r1 LUUry i r eUdL1G HEALTH SERVICES Report #5255 <br /> ENVTRONh1E:NTAL :HEALTH DIVISIOhd Statement Printed : 12 /18/96 <br /> 3P.41--'F iWEBER AVENUE — 3R,D FLOOR <br /> PC BOX 388 <br /> STOCKTON , CA 95201-0383 <br /> Accounting Office : 209 463-3420 <br /> I <br /> t 4 <br /> TO : CARPENTER COMPANY INCLou <br /> Pq E3OX 279 [Ec- t #f ::O�O00E29 <br /> LATHROP , CA 95330 <br /> E1-1iitLyI D 00021 ` <br /> . d <br /> RE : CARPENTER COMPANY INC <br /> 1-710'0. g' ,H A.R.I"A,N' R-0-- .•L:'A TF R- P <br /> MASE 111111 a COPY of THIS STATEI111 with YOUR 111111T j <br /> Service Activity I <br /> Date Description H r s Employee AmoUnt 1 <br /> j Invoice #E 034329 - - Date of Invoice : 12/17/96 <br /> ! 12/17/96 2380 UST Permit Fee Tank # TAISS701 L17 . <br /> Total for this invoice : $170. 00 , <br /> I Payment DUE DATE 01/18/97 <br /> If this INVOICE has been Paid, Please Disregard this Notice . <br /> i <br /> PAYMENT <br /> 217501FIVEP <br /> JAN 151997 � <br /> SAN JOAQUIN COUNTY <br /> HEALTH SERVICES <br /> ! ENVIRONMENTAL HEALTH DIVISION <br /> w 1 <br /> I # <br /> PENALTIES for all FEES for SERVIC€ will be ASSESSED <br /> PENALTIES will be ASSESSED on all ANNUAL PERKIT Fe at the rate of 10% of the Service Fee <br /> at the rate of 100t of the Base Fee 30 days after the Payment DUE DATE <br /> 39 days after the Payment DUE DATE, and EACH 30 days thereafter. <br /> TOTAL DUE_ this Billing Period: X170 .00 <br /> I Please Make CHECKS PAYABLE to :' F> 0...1I <br />• � �� $170 , 03 _ $0 . 0q�� $�i . 00�w g0 00 _ 4 00 <br /> � $1.70�00©0 <br /> 0 to 30 days 31 to 60 days 61 to 90 days 91 to 120 days } 120 days Account <br /> i Balance ! <br /> I <br /> � � i <br />