Laserfiche WebLink
PUBL11' I HEALTH SERtCES <br />�O•.P�:u l N• •. <br />SAN JOAQUIN COUNTY <br />JOGI KHANNA M.D., M.P.H. <br />Health Officer <br />P.O. Box 2009 • (1601 East Hazelron Avenue) • Stockton, California 95201 4cFOR�,� <br />(209) 468-3400 <br />ENVIRONMENTAL HEALTH DIVISION - UNIT III <br />BILLING STATEMENT <br />(209) 468-3427 <br />FACILITY ADDRESS: -4 SWEEPS # <br />BILL TO: .&-, <br />P <br />BILLING • '1 'r'/ <br />CITY/STATE: S r /IM::dd� <br />PROGRAM: t�� Y",BILLING DATE: <br />THE MINIMUM TWE FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br />NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br />DATE <br />of <br />SERVICE <br />TOTAL <br />HOURS <br />WORKED- <br />WEEKDAY <br />$53.00/HR <br />WEEKNIGHT <br />WEEKEND/ <br />HOLIDAYS <br />CONSUL- <br />TATION at <br />OUR <br />DESCRIPTION <br />of WORK <br />�ovo. <br />r�i�rn <br />ess�ss�� <br />;emu <br />BALANCE DUE: . PAYMENT IS TO BE RECEIVED 30 DAYS FROM THE BILLING DATE. <br />PENALTIES WILL BE APPLIED TO PAST DUE ACCOUNTS 30 DAYS FROM BILLING DATE. <br />RETURN ONE (1) COPY OF THIS BILL ALONG WITH PAYMENT. MAKE CHECKS PAYABLE TO: <br />PUBLIC HEALTH SERVICES -ENVIRONMENTAL HEALTH DIVISION (PHS-EHD). <br />EH 23 074 (Rev 1/14/91) <br />n of San Joaquin Counry Health Care Services 10 <br />