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cn y �UnyUarr LVVN I r HUdLIC HEALTH SERVICES Report 152S5 <br /> rj{VS$ONfIENTAL HEALTH DIVI" 'ON St,� ' ment Printed : 12/18/96 <br /> 'cc E l EBER AVENUE — 3RD A�dOR <br /> PO BOX 388 <br /> STOCKTON, CA 9201-0388 <br /> Accounting Office : 209 468-3420 <br /> I <br /> 3 a"'e •,•• c:::r <br /> 1'0 : THORSEN TRUCKING <br /> 2248 W TELEGRAPH Account # 0003354 <br /> STOCKTON , CA 95204-(Cy% <br /> ATTN : THORSEN TRUCKIN Facility ID 003774 <br /> RE.- THORSEU._TfRUCKING: <br /> 2800 TURri1PIH;E RD STOCKTON <br /> PLEASE RETURN a tOPT of THIS STATEMENT with YOUR PAYMENT <br /> ---.— - - - -�— Service Activity <br /> Date Description Hrs Employee Amount <br /> L <br /> Invoice # 034534 -- Date of Invoice : 12/17/96 <br /> 12J17/96 2380 UST Permit Fee Tank # TA174201 _ -$170 . 00 <br /> - <br /> Totalfor this invoice :-` $170 . 00 <br /> Payment DUE DATE 01/18/97 <br /> If this INVOICE has been Paid, Please Disregard this Notice <br /> JAN 211997 <br /> SAN JOAiIjiry LoWN I <br /> PUBLIC HrALTH SERuICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PENALTIES for all FEES for SERVICE will be ASSESSED <br /> PENALTIES will be ASSESSED on all ANNUAL PERMIT Fe at the rate of III of the Service Fee <br /> at the rate of lei% of the Base Fee 31 days after the Payment DUE DATE <br /> 31 days after the Payment DUE DATE. and EACH 30 days thereafter. <br /> TOTAL DUE this Billing Period: F— t170�-00 <br /> Please Make CHECKS PAYABLE to : IP" 1. 1 :."T:.; ,,o" p;=!: R-1 IFb <br /> $170 . 00 $0 . 001 $0 . 00 $0 . 00 $0 . 00 $170 . 00 <br /> —Lj <br /> 11 <br /> 1 to 31 days 31 to 61 days 61 to 9/ days 91 to 120 days ) 121 days Account _ <br /> Balance <br />