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} <br /> SANJti Qt3?dI COUNTY PUBLIC EALTH SERVICES Report #5255 <br /> fT I'R L4NTAL HEALTH DIVIWN Stoment Printed: 02/22/96 <br /> 304 ;* WEBER AVENUE - 3RD TLOOR <br /> PO BOX 388 <br /> STOCKTON, CA 95201-0388 <br /> Accounting Office : 209 468-3420 <br /> 11rlvoica <br /> TO: SALVATION ARMY PARKING LOT <br /> 30840 HAWTHORNE BLVD Account # 0010244 <br /> RANCHO PALOS VERDES, CA 90275 <br /> ATTN: CAPT VICTOR DOUGHTY Facility ID 0070777 <br /> RE: SALVATION ARMY PARKING LOT III <br /> 123 - N"'STANISLAUt" ST_ STOCKTON <br /> PLEASE RETURN a COPY of T�'S' STATEMENT with YOUR PAYMENT <br /> Date Description Service Activity <br /> Hrs Employee Amount <br /> Invoice # 023700 -- Date of Invoice: 10/23/95 <br /> 10/23/95 PAYMENT $-468 . 00 <br /> 10/13/95 2380 UST PERM CLOSURE PLN CHCK/INS 1 . 5 BRIGGS $117 . 00 <br /> 10/16/95 2380 UST PERM CLOSURE PLN CHCK/INS 1 . 5 BRIGGS $117 . 00 <br /> 10/23/95 2380 UST PERM CLOSURE PLN CHCK/INS 4 . 0 BRIGGS $312 . 00 <br /> 10/24/95 2380 UST PERM CLOSURE PLN CHCK/INS 1 . 0 BRIGGS $78 . 00 ! <br /> 11/03/95 2380 UST PERM CLOSURE PLN CHCK/INS 2 . 0 KNOLL $156 . 00 Y� <br /> 11/22/95 2380 UST PERM CLOSURE PLN CHCK/INS 0 . 5 BRIGGS $39 . 00 <br /> 01/15/96 Service-based Penalty $15 . 60 <br /> 12/11/95 2380 UST PERM CLOSURE PLN CHCK/INS 0 . 5 BRIGGS $39 . 00 <br /> 01 /15/96 CORRECTION TO A CHARGE(PENLTY IN ERROR) $-15 .60 <br /> 01/23/96 2380 UST PERM CLOSURE PLN CHCK/INS 0 . 2 BRIGGS $15 .60 < <br /> ------------------------------------- <br /> Total for this invoice: $405 .60 <br /> If this INVAI6.haa4ee� Paid Please Diare and this Not.ce Payment DUE DATE 03/23/96 <br /> .. , ,d 11 11 <br /> 9 .. <br /> OiAVMENT <br /> ri PAYMENT <br /> MAY 2 4 1996 AY 2 4 1996 <br /> SAN JC)r,COii� Uut, al 1SAN JUriuUlly' C'UL,fil 9 <br /> PUBLIC HEALTH SERVICES PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH DIVISION <br /> PENALTIES for all FEES for SERVICE will be ASSESSED <br /> PENALTIES will be ASSESSED on all ANNUAL PERMITS at the rate of 10% of the Service Fee <br /> at the rate of 109% of the Base Fee --- - 30 days after the Payment DUE DATE <br /> 30 days after the Payment DUE DATE. and FACS 30 days thereafter. <br /> TOTAL DUE this Billing Period: 54005 . 6 <br /> : <br /> Account 1-30 Days 31-60 Days 61-90 Days 91-120 Days 121+ Plu� <br /> Summary — <br /> 15 . 60 0 . 00 0 . 00 390 . 00 0 . 00 <br /> 0 is <br />