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F SAN,JOAQUIN COUNTY PUBLIC HI Po�lH SERVICES Page 1 j <br /> ENViAOI MENTAL HEALTH DIVISl <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209-468-3420 <br /> j <br /> INVOICE Account I AR0011154 <br /> Facility I FA0007409 <br /> Date Printed 12%30/99 <br /> ST JOSEPHS IMME CARE/SIMBALENK RE : ST JOSEPHS IMMEDIATE CARE <br /> ST JOSEPHS IMMEDIATE CARE 2333 W MARCH STE A LN <br /> PO BOX 213008 STOCKTON CA 952139008 <br /> STOCKTON CA 952139008 OWNER: ST JOSEPHS IMMEDIATE CARE <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0066632---Date of Invoice: 11/19/99 <br /> I <br /> 11/18/1999 4557 MED WASTE LIMITED HAULER EH Operating Permit Fee $67.00 <br /> Total for this Invoice $67.00 <br /> Payment Due Date 5/16/2000 <br /> TOTAL DUE this Billing Period $67.00 <br /> Please make Checks PAYABLE to: PHSIEHD 1 Return a Copy of This STATEMENT with Your PAYMEN <br /> Penalties will be added to all Permit Fees For all SERVICE FEES <br /> at the Rate of 100%ofthe Base Fee penalties will be added at the Rate of 10% <br /> 30Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> i <br /> PAYIF�KT <br /> Sir. <br /> DEC 2 3199 <br /> SAN JOAOU N _ <br /> PUBLIC HEALfH <br /> ENVIRONMENTAL HEALTh D'VISiC'n <br /> 5255.rpt <br />