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Stateme' <br />209 468—3420 <br />X ri v o .X o o <br />TO: <br />Account #0004234 <br />Facility ID 004505SAN JOAQUIN CO UTIL MAINT DISTATTN : <br />RE : <br />PLEASE RETURM a COPY of THIS STATENEHT with YOUR PAYMENT <br />DescriptionDate Amount <br />05/20/99 <br />$400.00 <br />If this INVOICE has been Paid, Please Disregard this Notice <br />TOTAL DUE this Billing Period:$400.00 <br />PHS/EHDPlease make Checks PAYABLE to: <br />Penalties will be added on all Permits <br />at the rate of IDOL of the Base Fee 30 <br />days after the due date. <br />Total for this invoice: <br />Payment DUE DATE <br />Service Activity <br />Hrs Employee <br />FAIROAKS PUS #44 <br />FAIROAKS/BATES RD <br />TRACY <br />$400.00 <br />06/20/99 <br />For all SERVICE FEES penalties will <br />be added at the rate of IM 60 days <br />past invoice date and each 30 days <br />thereafter. <br />SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVtRONMENTAL HEALTH DIVISION <br />T;4^E WEBER AVENUE <br />STOCKTON, CA 95202 <br />Accounting Office: <br />IL A g <br />— <br />Invoice # 062189 — Date of Invoice: <br />05/20/99 4622 Public Water System Permit Fee <br />FAIROAKS PWS #44 <br />1702 E SCOTTS AVE <br />STOCKTON, CA 95205 <br />Report 052SS <br />Printed: 05/20/99