Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMF Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0026781 <br /> Facility ID FA0015509 <br /> Date Printed 8/20/2004 <br /> ST FRANCIS MOTEL RE : ST FRANCIS MOTEL <br /> 5708 N HWY 99 5708 N HWY 99 <br /> STOCKTON, CA 95212 STOCKTON, CA 95212 <br /> OWNER : PATEL, GIRISHKUMAR K <br /> Date Health <br /> Program Description Amount � <br /> Invoice# IN0122311 —Date of Invoice : 7/8/2004 I IIIIIII IIIIII III VIII IIIII IIIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> Hrs Employee <br /> 7/7/2004 3030 310-FIELD CONSULT 0.80 INFURNA $ 74.40 <br /> 7/8/2004 9999 PAYMENT ($ 279.00) <br /> 7/8/2004 3030 315-REPORT REVIEW 1.40 INFURNA $ 130.20 <br /> 7/28/2004 3030 310-FIELD CONSULT 0.80 INFURNA S 74.40 <br /> 7/29/2004 3030 312-CONSULTATION 0.40 INFURNA $ 37.20 <br /> Total for this Invoice $ 37.20 <br /> Payment Due Date 9/19/2004 <br /> TOTAL DUE this Billing Period $ 37.20 ' <br /> PECE VED <br /> R <br /> SEp 3 20Oh <br /> cOUN-� <br /> SA EN�IRONUM <br /> MPREWN- <br /> TMENT <br /> HEpd-TH ptvF <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For OES I HMMP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Da s her <br /> 5255 rpt UU111 ILILIN I 1i <br />