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QNVIP.ONMENTAL. HEALTHyDI`JI Printed : 12 /19 /96 <br /> 304 E WEBER AVENUE - 3RD Ci0 <br /> PO BOX 388 <br /> STOCKTON , CA 95201-0388 <br /> Accounting Office : 209 468--3420 <br /> TO : SOUZA REALTY & DEVEL - - - = <br /> 105 E 10TH ST Account 0009397 <br /> TRACY • CA 95376 = = <br /> ATTN : MICHAEL SOUZA Facili y jDj 006798 <br /> RE : SOUZA PROPERTY <br /> ,FABIAN & LAP' MERS RD TRACY <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> Date Description H r s Employee Amount <br /> Invoice # 015434 -- Date of Invoice : 11/17/94 <br /> 11 /18/94 PAYMENT $-390 . 00 <br /> 11 /15/94 2953 REPORT REVIEW 1 . 5 INFURNA $117 . 00 <br /> 11 /1-6/94 2953 CONSULTATION 1 . 0 INFURNA $78 . 00 <br /> 11 /1.6./94 2953 OT REPORT REVIEW 1 . 1 INFURNA $128 . 70 <br /> 11 /17 /94 2953 REPORT 'REVIEW 2 . 3 INFURNA $179 . 40 <br /> 1.1 /18/94 2953 CONSULTATIOP� 0 . 3 INFURNA $23 .043 <br /> 12/Q�2/9.A._2953_ CONSULTATION 0 . 5 INFURNA $39 . 00 <br /> 12 /07/94 2953 REPORT REVIEW 1 . 43 114FURNA $78 . 00 <br /> 12/23/94 2953 FIELD CONSULT 1 . 5 INFURNA $117 . 00 <br /> 12/27 /94 2953 REPORT REVIEW 0 . 8 INFURNA $62:. ! 0 <br /> 02/13/95 PAYMENT ? 1 -432 . 90 <br /> 01/19 /95 2953 FIELD CONSULT 1 . 1 INFURNA $85 . 80 <br /> 432/28./95 2953 REPORT REVIEW 0 . 9 INFURNA $70 . 20 <br /> 03/02 /.95 2953 REPORT REVIEW 4 . 1 INFURNA $319 . 80 <br /> 03/03/95 2953 CONSULTATION 0 . 7 INFURNA $54 . 60 <br /> 03/06 /95 2953 REPORT REVIEW 1 . 1 INFURNA $85 . 80 <br /> 03/07 /95 2953 REPORT REVIEW 3 . 0 INFURNA $234 . 00 <br /> 03/09/95 2953 CONSULTATION 1 . 3 INFURNA $101 . 40 <br /> 03/01 /95 2953 REPORT REVIEW 6 . 0 INFURNA $468 . 00 <br /> 03/09 /95 . 2953 REPORT REVIEW 1 . 8 INFURNA $1.40 . 40 <br /> 08/01 /96 2953 REPORT REVIEW 1 . 3 INFUR MYMENT $101 . 40 <br /> 10/11 /96 PAYMENTRFCF-bRF`O6`, $-1 , 5 '" 0 <br /> Total for�thisiANVO9a997 ^$101 .40 <br /> Paym nt PAST U <br /> If this INVOICE has been Paid, Please Disregard this Notice . . . SAN JDAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> PENALTIES fort/a �oTrA4EggAjh[11\661MESSED <br /> PENALTIES will be ASSESSED on all ANNUAL PERN - at the rate of 108 of the Service Fee <br /> at the r.ate of 1008 of'the Base Fee 30 days after the Payment DUE DATE <br /> 30 days after the Payment DUE DATE. and `SACH 30 days thereafter. <br /> TOTAL DUE this BillingPeriod: $101 . 40 <br /> Please Make CHECKS PAYABLE to: N :'' A..0 "::::N �'� fl::::: 11 11 11-11 <br /> $0 . 00 <br /> $0 . 00 <br /> $0 . 00 $0$0$__ $101 . 40 $101 40 <br /> 0 to 30 days 31 to 60 days 61 to 90 days 91 to 120 days } 129 days <br /> Balance <br />