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H DIVI n00R1 SERVICES <br /> ENVIRONMENTAL !-IEALT1� DTVI Report #5255 <br /> 304 E1fWEBER AVENUE * Statement P1-i6ted : 01/23/96 <br /> PO 8#X 388 <br /> STOCKTON , CA 95201-0388 <br /> Accounting office , 209 468-3420 <br /> t...N : <br /> TO : C KELLEY TRUCKING <br /> 4969 E WATERLOO RD <br /> STOCKTON , CA 95205 Account 0003329 <br /> ATTN : C KELLEY TRUCKING INC —`° <br /> Facility ID 003750 <br /> RE : C KELLEY TRUCKING <br /> 4969 E WATERLOO RD STOCKTON <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Date Description Service Activity <br /> Mrs Employee Amount <br /> Invoice # 025683 Date of Invoice : 01/22/96 <br /> 01 /22/96 2380 UST Permit Free <br /> --`^Tank-----175401---_----^ 7/2 <br /> µ-00 <br /> Total for this invoice: <br /> Payment DUE DATE 0 , 0 <br /> If this INVOICE has been Paid, Please Disregard this Notice 01/9 <br /> r <br /> PAYMENJ <br /> REC IVFn <br /> FEB 5 199E <br /> SAN JCRCUIN COUNTY <br /> PULIC HEALTH SERVICES <br /> 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 108 of the Service Fee <br /> at the rate of Leet of the Base Fee <br /> 30 Says after the Payment DUE DATE, 30 days after the Payment DUE DATE <br /> and EACH 30 days thereafter. <br /> TONAL DUE this Billing Period: 0 <br /> Account =1-30 Days 31-60 Days 61-90 Days <br /> Summary 91-120 Days 223 Plus <br /> 170 . 00 0 . 00 0 . 00 0 . 00 <br /> 0 . 00 <br />