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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> <br /> <br /> yID FA0002451 <br /> Date Printed 1/29/2021 <br /> IN SHAPE HEALTH CLUBS INC RE : MARINA YACHT&TENNIS CLUB <br /> MARINA YACHT&TENNIS CLUB 6545 EMBARCADERO DR <br /> 6507 PACIFIC AVE kk3HSTOCKTON, CA 95219 <br /> ATTN: ACCOUNTS PAYABLE <br /> STOCKTON,CA 95207 OWNER : ROTHBARD, DR MORT <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0341153---Date of Invoice: 10/29/2020 <br /> I VIII II III III I II IIII I VII I III II III II VII I I IIII VII I(IIII VIII II II IIIIII 111111111 IIII <br /> 10/29/2020 3611 PUBLIC POOUSPA-PRIMARY $ 283.00 <br /> 10/29/2020 3612 PUBLIC POOUSPA-ADDITIONAL $ 141.00 <br /> Total forthis Invoice $ 424.00 <br /> Payment Due Date 12/512020 <br /> TOTAL DUE this Billing Period $ 424.00 <br /> WE`pl00 VMeo 1OOPY1 <br /> PA <br /> 0 <br /> S <br /> LT� I <br /> �- <br /> aP� ►rS�no�ec� <br /> Please make Checks PAYABLE to: 'EHD' <br /> Penalties will be added to all Permit Fees For HMBP 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 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> i25i.rpt <br />