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FlN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report #5255 <br /> --NVIRONMENTAL HEALTH DIVI— 7N Stal*-."e Printed : 05 /20/99 <br /> <br /> <br /> Accounting Office : 209 468-3420 <br /> r r-1 c> :i' C. a:E? <br /> TO : BIG 0 TIRES <br /> 940 CENTRAL AVE Account # '0016112 <br /> TRACY , CA 95376 _— — <br /> ATTN : DONALD JAY KRUPP Facility ID 009112 <br /> RE : BIG 0 TIRES #29 <br /> 940 CENTRAL A V E _w.,.: � .w..o..__...� .. . .�. . ._. <br /> TRACY <br /> 1 PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> Date Description Hrs Employee Amount <br /> Invoice #F 056356 -- Date of Invoice : 05/18/99 <br /> 05/18/99 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $18 . 50 <br /> Total for this invoice: X18 .50 <br /> Payment DUE DATE 6�/20 <br /> If this INVOICE has been Paid, Please Disregard this Notice _ -- <br /> 1 hjil <br /> ?rKs�,p <br /> Invo Dt <br /> ® w '`` ,., 2� �r':"fb "t#vV e3: es/1'8/9r3 <br /> $fit G L N .` a �'��r+.x;` rig: <br /> 05/18 /99 '2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10 . 00 <br /> ----------------------------------- <br /> Total for this invoice : 110.00 <br /> Payment DUE DATE <br /> If this INVOICE has been Paid, Please Disregard this Notice PAYMENT <br /> rj <br /> juNf <br /> SAN JaAC.lUN CC-MrV <br /> PUBLIC HFA`_'rs+9E4'd S5-C— <br /> ENVIRONIAENTALHFAITHCNv ? 11 SERVICE FEES penalties will <br /> Penalties will be added on all Permits be added at the rate of 10% 69 days <br /> at the rate of 1996 of the Base Fee 36 past invoice date and each 36 days <br /> days after the due date. thereafter. <br /> TOTAL DUE this Billing Period: $128.50h <br /> Please make Checks PAYABLE to : PHS/EHD <br />