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1 '_)'AN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report #5255 ' ENVIRONMENTAL HEALTH DIVISION 445 N SAN JOAQUIN STREET - PO BOX 388 `,TOCKTON , CA 95201-0388 Accounting Office : 209 468-0340 •�Y C K::: Ck k..A a'...a 1::. 11 f A... T0 : ATAD , C ROSE " 39-40 - 5125 S KAISER RD # 0002366 STOCKTON , CA 95205 ATTN : ATAD , ROSE 9 MARTIN ID 002806 RE : A GO C ROSE 39,, 40, ate : 12/131,-zi 51'25 S KAISER RD STQ.0�T0N NT PLEASE RETURN THIS STATEMENT WITH YOUR PAYMENT �3VE D 31995 Service Activity !INC()UNTY �__� ,TI-I 51_ 0aate gesC.ripti.on H r s Em P HEALTVA Tfafi Invoice # 008981 -- Date of Invoice : 03/17/94 02/11 /94 4630 LEGAL ACTION/INVESTIGATION 3 . 0 BOR $234 . 00 06/15/94 Service-based Penalty $23 . 40 07/15/94 Service-based Penalty $23 . 40 08/15/94 Service-based Penalty $23 . 40 Total for thi C304 . 20 If this INVOICE has been Paid , Please Disregard this P =.nd DEDUCT the Amount Paid from the InvoiceOI745�}- # --=-- -- Date of Invoice : 06/10/94 05/02/94 2'700 INSPECTION/REINSPECTIONO&51 S' 1 . 0 BA $78 . 00 05/16/94 2700 INSPECTION/REINSPECTIONot,7%23 1 . 0 BA $78 . 00 05/31 /94 2755 INSPECTION/REINSPECTION 1 . 0 RO $78 . 00 08/15/94 Service-based Penalty $23 . 40 09/16/94 Service-based Penalty $23 . 40 10/15/94 Service-based Penalty $23 . 40 Total for th : $304 . 20 I 'f this INVOICE has been Paid , Please Disregard this -.and DEDUCT the Amount Paid from the Invoice # 011224 -- Date of Invoice: 07/12/94 07/12 /94 4630 Public: Water System Permit Fee $350 . 00 Tot.e.l for t $350 .00 If this INVOICE has been Paid , Please Disregard this . . . and DEDUCT the Amount Paid from th IE Invoice # 014043 -- Date of Invoice: 08/15/94 07 /22/94 2755 INSPECTION/REINSPECTION 1 . 0 R 07 /29/94 2755 INSPECTION/REINSPECTION 1 . 0 R I