Laserfiche WebLink
�N JOAQUIN COUNTY PUBLIC HEALTH SERVICES Coni Report #5255 <br /> NVI,RONMENTAL HEALTH DIVIN St*ent Printed : 01/29/99 <br /> 94 E WEBER AVENUE — 3RD IROR <br /> STOCKTON , CA 95202 <br /> Accounting Office : 209 468-3420 <br /> 31 5— c go <br /> TO : DOCTORS HOSPITAL OF MANTECA B ECEIVEE — <br /> 1400 FLORIDA AVE STE 204 Account # 0000851 <br /> MODESTO , CA 95350 FEB – it, 19�a <br /> ATTN : DRS HOSP OF MANTECA/ACCTS PAYFacility ID 000853 <br /> RE : DOCTORS HOSPITAL OF MANTECA <br /> 1205 E NORTH <br /> MANTECA <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> Date Description Hrs Employee Amount <br /> Invoice 053995 -- Date of Invoice: 01/28/99 <br /> 01/28/9 UNIFIED PROGRAM FAC STATE SERVICE FEE —S �n�c $10 . 00 <br /> 01/28/99 2315 UST Permit Fee Tank # TA144602 $170 . 00 <br /> 01/28/99 2234 HAZARDOUS WASTE CESW FACILITY PERMIT $100 . 00 <br /> ') Auer CGcvrery— --------y— — ---------�— <br /> ment DUE DATE <br /> ---- -------- . <br /> Total for this invoice : 00= <br /> � <br /> 1 <br /> If this INVOICE has been Paid, Please Disregard this Notice Pa <br /> OF MANTECA <br /> P4AYNO a- <br /> PEC-P2-';�f.4,.' P.O.Nu",4 <br /> FEB 2 2 1999 APPS A <br /> WsiONa�ccx� <br /> P BUB L J TH r`-RVICES <br /> �iq Ji CJMEWTAL HEALTH DMS ION <br /> ACCiJUrRT QGBI Efl <br /> For all SERVICE FEES penalties will <br /> Penalties will be added on all Permits be added at the rate of lit 61 days <br /> at the rate of 1102 of the Base Fee 31 past invoice date and each 31 days <br /> days after the due date, thereafter. <br /> TOTAL DUE this Billing Period : 5280 .00 <br /> Please make Checks PAYABLE to : PHS/EHD <br />