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MIA vMy !ir <br /> ENVIRONMENTAL HEALTH DIVISION SY..atement Printed : 01 /20 (98 <br /> ?04 E WEBER AVENUE — 3RD FL t/ <br /> ST?,,CKT16N , CA 95202 <br /> Accounting Office : 209 468-3420 <br /> e'-k <br /> T0 : PAYLESS DRUG STORES #6000 - =-- <br /> PO BOX 3165 Account # 0000380 <br /> HARRISBURG , PA 17105 <br /> ATTN : KAREN FERRANTE p Facility ID 000381 <br /> RE : PAYLESS DRUG STORES #6000 RRRR <br /> 520 W LODI AVE <br /> LODI <br /> PLEASE RETURN a COPY of THIS STATEMENT With YOUR PAYMENT <br /> Service Activity <br /> Date _ Description J Hrs Employee Amount _ <br /> IIIlnvoice N 013895 -- Date of Invoice : 12/12/97 <br /> 12/12/97 2399 UNIFIED PROGRAM FAC STATE SERVICE FEETank #PR5O6925 $18 . 50 <br /> 12/12/97 2213 F;AZ WASTE CE FAC STATE SERVICE FEE $20 . 75 <br /> --------------- <br /> Total for this invoice : C39 . 25Payment DUE DATE <br /> If this INVOICE has been Paid, Please Disregard this Notice <br /> Invoice 0 044426 -- Date of Invoice : 12/12/97 <br /> 12/12/97 2233 14AZARDOUS WASTE CESQT FACILIT-Y PERMIT $100 . 00 <br /> :98J Total for this invoice : $100Payment DUE DATE 01/12 <br /> If this INVOICE has been Paid, Please Disregard this Notice PAYMENT <br /> RECEIVED <br /> ED <br /> JAN 16 1998 <br /> SAN YJl1GUlN r..�,.,,_ . <br /> PUBLIC Hr,,LTH SL!RV c;,f. <br /> ONS QN (dfRrEr +N6PpGNmWWS Will <br /> Penalties Will be added on all Permits be added at the rate of 104 60 days <br /> at the rate of 1004 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 : $139 .25 <br /> Please make Checks PAYABLE to : PNS/EHO <br /> ,Now -"W <br />