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jAQUIN COUNTY PUBLIC HEALTH SERVICES <br />c��IMENTAL HEALTH DIVISV <br />E WEBER AVE - 3RD FLOOR <br />,'OCKTON, CA 95202 <br />109-468-3420 <br /> <br /> <br /> <br /> <br />INVOICE <br />Page 1 <br />Account IDL <br />AR0003337 <br />Facility ID <br />FA0003758 <br />Date Printed <br />5/15/00 <br />RE: RYDER TRUCK* <br />3633 DUCK CREEK DR <br />STOCKTON CA 95215 <br />OWNER: RYDER TRUCK <br />Health <br />Date Program Description Firs Employee Amount <br />Invoice # IN0069541 --- Date of Invoice : 4/19/00 <br />4/19/2000 <br />2220 <br />SM HW GEN <5 TONS/YR <br />4/19/2000 <br />2301 <br />UST STATE SURCHARGE <br />4/19/2000 <br />2360 <br />Underground Storage Tank EH Operating Permit Fee <br />Tank # 001 <br />4/19/2000 <br />2360 <br />Underground Storage Tank EH Operating Permit Fee <br />Tank # 002 <br />4/19/2000 <br />2360 <br />Underground Storage Tank EH Operating Permit Fee <br />Tank # 003 <br />4/19/2000 <br />2360 <br />Underground Storage Tank EH Operating Permit Fee <br />Tank # 004 <br />4/19/2000 <br />2399 <br />UNIFIED PROGRAM FAC STATE SERVICE FEE <br />5255. rpt <br />Total for this Invoice <br />$100.00 <br />$32.00 <br />$170.00 <br />$170.00 <br />$170.00 <br />$170.00 <br />$10.00 <br />$822.00 <br />Payment Due Date 6/14/2000 <br />TOTAL DUE this BillingPeriod $822.00 <br />Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br />Penalties will be added to all Permit Fees For all SERVICE FEES <br />at the Rate of 100% of the Base Fee Penalties will be added at the Rate of 10 <br />30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br />l <br />v;,,�Z'JiN GuUNTV �, <br />- gFnV <br />'U.;LIC i�ALTH nq it5;0�" <br />