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SAN 3OAQUZN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRO ����~� <br /> �NTAL HEALTH DIVMON Report #5255 <br /> ---- <br /> 44� N' 8AN JOAAUIN STREET <br /> PO BOX 388 <br /> STOCKTON ^ CA 95201-0388 <br /> Accounting office : 209 468-0340 <br /> Ch ILA m <br /> TO : C KELLEY TRUCKING <br /> 4969 E WATERLOO RD <br /> STOCKTQN ° CA 95205 FAcCount 4 (@)@033'2Q9 <br />� ATTN : C KELLEY TRUCKZNO INC <br /> LFa c Lij I i Lty]=0 <br /> R[ : C KELLEY TRUCKING 003750 <br />� 4969 E WATERLOO RD STOCKTON Billing Data : 01 /11/95 <br />� <br /> PLEASE RETURN THIS STATEMENT WITH YOUR p4YM0T <br /> Date Description Service Activity <br /> Hrs Employee Amount <br /> Invoice # 016985 -- Date of Invml <br /> 01 /11 /95 2380 Underground Tank p ue � 01/11/Q5 <br /> ermi� Fee <br /> ___________________________ <br /> If this IN"VOICE has been Paid , Please Dl Total for this invoice � — <br /> and DEDUCT he Amount � regard this Notice , ^ <br /> ^ unPaId from the TOTAL DUE ' <br /> Penalties will be added on all PERMIT F <br /> at the rate of 100% of the Base Fee <br /> cc��r»���r <br /> 60 days after theinvoice <br /> For all SERVICE FEES n»« ue da�e . �N$/��w�.�W#L��mmm,~'~' <br /> penalties will <br /> be added at the rate of 1W� <br /> 60 days post the invoice dote and <br /> each 30 days thereafter , <br /> TOTAL DUE this Billing Period: <br /> Account [:E3 <br /> 61— <br /> Summary - 61-90 Days 91 120 Day" 121+ plus <br /> 170 . 00 0 . 00 0 . 00 0 . 00 <br />