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SAN JOA U fd OUfdTY PUBLIC HLHL"iH SERVICES Stat sant Printed : r 12 /18 /96 II <br /> g�AVI�DfdMENTAL HEALTH DIVISIr'rN <br /> 3.9x4 EY'" WEBER AVENUE — 3RD OOR <br /> PO BO'X 388 <br /> STOCKTON , CA 95201-0"388'" <br /> Accounting Office : 209 468-3A20 <br /> .t 1T <br /> To : TED PETERS TRUCKING COMPANY Account ft 000�2� <br /> PO BOX 831 <br /> MANTECA , CA 95336 ' <br /> ATTN: ,. DRVID PETERS ETAL <br /> Facility IO 00399 <br /> RE : TEO.�PETERS ,TRUCK..1hNG._C_O-M PAN Y. <br /> 1985, W YOSEMITE MANTECA <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR P� ,r'T <br /> �— Service tivity —� <br /> Hrs ", ployee Amount <br /> Date Description _ <br /> Invoice k 034655 -- Date of Invoice : 12/17/96 <br /> Fee <br /> Tank # TA142701 _------ $17© • o0 <br /> 12/17 /96 2380 UST Permit. <br /> Total for this invoice : $170. 00 <br /> Payment DUE DATE 01/18(97 <br /> If this INVOICE has been Paid, Please Disregard this Notice . . <br /> PAYMENT <br /> RE CERf IF n� <br /> JAN 0 1997 <br /> .SAN)QAQUfI*Wt1NTY <br /> PU0WC W KTH$C`pVIQEiS . <br /> ENVIRONMfeNTAL 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 10% of the Service Fee <br /> at the rate of 1003 of the Base Fee 3B days after the Payment DUE DATE <br /> 30 days after the Payment DUE DATE. and EACH 30 days thereafter. <br /> TOTAL DUE this Billing Period: $170_00 <br /> Please Make CHECKS PAYABLE to: Nc"' 0 B `•:i$ w�. Ni ii p 0 II:::A <br /> $170 . 00 $0 . 00 $0 . 00 $0 . 000© $170 . P4 <br /> 0 to 30 days 31 to 60 days 61 to 90 days 91 to 120 days ) 120 days Account\ <br /> Balance <br /> A <br />