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SAN ,JOAQUIN COUNTY 'PUBLIC H,E'�ALTH SERVICES Report #5255 <br /> E:N4,1 RirgMENTAL HEALTH DIVON Stent Printed : 11/18 /99 <br /> 304 E WEBER AVENUE -- 3RD9 OOR <br /> STOCKTON , CA 95202 <br /> Accounting Office : 209 456-3420 <br /> TO : FONZIA CORPORATION <br /> 1001 TAHOE BLVD Account # 0015055 <br /> INCLINE VILLAGE , CA 89451-981_ . <br /> ATTN : DOUG DRIVER Facility ID 008031 <br /> RE : FORTIFIBER <br /> 501 E ACACIA ST <br /> STOCKTON <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> Date Description Mrs Employee Amount <br /> I Invoice—# 065187 -- Date of Invoice : 10/21/99 <br /> 09 /02 /99 2960 REPORT REVIEW 0 . 5 OZ $39 . 00 <br /> Total for this invoice: •� <br /> Payment DUE DATE 1 1 9 <br /> If this INVOICE has been Paid, Please Disregard this Notice <br /> For all SERVICE FEES penalties will <br /> Penalties will be added on all Permits be added at the rate of 108 60 days <br /> at the rate of 1008 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 : $39 . 00 <br /> Please make Checks PAYABLE to : PHS/EHD <br /> p�C 6 1 <br /> S"N juiQlu,'N:'Jid.Jy <br /> PUBLir 144\1.T.H SERVICES <br /> EtJVpuaL cY1"iALriEALTHONISION <br />