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SAN JOAOUIN COUNTY P BLI- :ALTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALT DI v_,,ION <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> RE : COUNTRY CLUB SERVICE <br /> COUNTRY CLUB SERVICE 1403 W COUNTRY CLUB BLVD <br /> 1403 W COUNTRY CLUB BLVD STOCKTON CA 95204 <br /> STOCKTON CA 95204 <br /> OWNER: CRAIG FURGISON <br /> Health <br /> Date Program Descriptiop Hrs Employee Amount <br /> Invoice# IN0080307---Date of Invoice: 1130/01 <br /> 1/30/2001 2220 SM HW GEN<5 TONS/YR $100.00 <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $110.00 <br /> Payment Due Date /2/2001 <br /> TOTAL DUE this Billing Period $110.00 <br /> Please make Checks AYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be addt d to all Permit Fees For all SERVICE FEES <br /> at the Rate of 100°0 of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after I he Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> PIaY IVI E NT <br /> RECEIVED <br /> FEB 1 6 2001 <br /> s^ Ir ,�I colj ITY <br /> 5255.rpt <br />