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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report 15255 <br /> ENVIRONMENTAL HEALTH DIVIS' ! Stat�.ent Printed : 01 /26/98 <br /> 304 E WEBER AVENUE — 3RD FLUOR <br /> STOCKTON , CA 95202 <br /> Accounting Office : 209 468-3420 <br /> TO : CARL KARCHER ENT —v'—'- <br /> 800 MELLON AVE Account # 0003269 <br /> MANTECA , CA 95336 ° <br /> ATTN : CARL KARCHER Facility ID 003691 <br /> RE : CARL KARCHER ENT <br /> 800 MELLON AVE <br /> MANTECA <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> LDDescription.tio Hrs Employee Amount <br /> y <br /> Invoice # 044065 -- Date of Invoice : 12/12/97 <br /> 12/12/97 2380 UST Permit Fce 111)-t 1 Tank # TA163601 $170 . 00 <br /> 12/12/97 2380 UST Permit Fee IIQ.YIC V Tank # TA168602 $170. 00 <br /> 12/12/97 2399 UNIFIED PROGRAM FAC STATE SERVICE FEETank #PR507405 $18 . 50 <br /> 12/12/97 2301 UST State Surcharge Fee Tank # PR507724 $8 . 00 \ <br /> --------------- <br /> --( <br /> Total for this invoice : $366 . 59 ` <br /> Payment DUE DATE 01/12/98 J <br /> If this INVOICE has been Paid, Please Disregard this Notice �--� <br /> PAYMENT <br /> MF <br /> JAN 2 6 1998 <br /> S.AN JOAOUITy COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH CIVISION <br /> For all SERVICE FEES penalties will <br /> Penalties will be added on all Permits be added at the rate of 10t 60 days <br /> at the rate of 100: of the Base Fee 30 past invoice date and each 30 days <br /> days after the due date. thereafter. <br /> TOTAL DUE this Billing Period : _ $36650 <br /> Please make Checks PAYABLE to : PHS/EHO <br />