Laserfiche WebLink
Neporc eaLaz <br /> SAN J'DA©UIN COUJTY PUBLIC IEOALTH SERVICES g tement Printed : 12 /18/96 <br /> -FNVIRONMENTAL HEALT DI <br /> 304 E "WEBER AVENUE — 3R L <br /> PO BOX 388 <br /> STOCKTON , CA 95201`0388 <br /> Accounting Office : 209 466 <br /> TO : LOCAL FOOD STORE #1� Account # 0003424 <br /> 2650 MONTE DIABLO ST —=---_ �— <br /> STOCKTON , CA 95203 l r� � Ix,� Io� <br /> ✓J vl/ / ( ' Facility I[) 003836 <br /> ME[D KHAN <br /> ATTN : HA NSTOCKTON <br /> .,..__,__,.. .. <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT _ <br /> Service Activity <br /> Hrs Employee Amo Unt <br /> Date Description �� <br /> Invoice # 034576 -- <br /> Date of Invoice : 12/17/96 70 - 00 <br /> # TA119101 C "111 L $170 . 00 ' <br /> 12 /17 /96 2380 UST Permit Fee Tank # TA119102 $117© .©© <br /> 12 /17 /96 2380 UST permit Fee Tank # TA119103 <br /> 12/17 /96 2380 UST Permit Fee —_T--------------------- <br /> $510 . 0 <br /> Total for this invoice: 01 /18J9 <br /> Payment DUE DATE <br /> If this INVOICE has been Paid, Please Disregard this Notice . . <br /> P AYMENI <br /> oe"r� ,e neT <br /> JAN 16 1997 <br /> SAN JOAOUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PENALTIES for all FEES for SERVICE will be ASSESSED <br /> at the rate of 102 of the Service fee <br /> PENALTIES will be ASSESSED on all ANNUAL PERMIT Fe 30 days after the Payment DUE DATE <br /> at the rate of 1008 of the Base fee and EACH 30 days thereafter. <br /> 30 days after the Payment DUE DATE. <br /> Period : $510 .00 <br /> TOTAL DUE this Billing �^ <br /> II'.',. 0....p .F6 ,f" IF.!". IL...D A:)Please Make CHECKS PAYABLE t ._. <br /> $510 . 00 <br /> L� �_�-z — Account <br /> 0 to 30 days 31 to 60 days 61 to 90 days <br /> 91 to 120 days ) t20 days <br /> Balance <br />