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t;AN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report 15255 <br /> 1ENVIRONMENTAL HEALTH DI ION S*ement Printed : 05/20/99 <br /> %04 E WEBER AVENUE — 3RMWLOOR <br /> STOCKTON , CA 95202 <br /> recounting Office : 209 468-3420 <br /> TO : KRAGEN AUTO PARTS #1137 <br /> PO BOX 6030 <br /> PHOENIX , AZ 85005 Account # 0017400 <br /> ATTN : KM BOWLES RISK MGMT DEPT Facility ID 010400 <br /> RE : KRAGEN AUTO PARTS #1137 <br /> 430 E CHEROKEE LN <br /> LODI <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> Date Description — Hrs Employee Amount <br /> nvoice # 057523 -- Date of Invoice: 05/18/99 <br /> 05/18/99 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $18 . 50 <br /> ------------------------------------- <br /> Total for this invoice :Payment DUE DATE <br /> If this INVOICE has been Paid, Please Disregard this Notice <br /> nvoice # 059726 -- Date of Invoice : 05/18/99 <br /> 05/18/99 2220 SM HW GEN <5 TONS/YR $100 . 00 <br /> ;18/99 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE , 0 <br /> ---------------------- --.._. <br /> Total for this invoice : 110. 00 <br /> If this INVOICE has been Paid, Please Disregard this Notice Payment DUE DATE 0 20 <br /> For all SERVICE FEESP enalties will <br /> Penalties will be added on all Permits be added at the rate of 108 60 days <br /> at the rate of 1008 of the Base Fee 30 past invoice date and each 30 days <br /> days after the due date. thereafter. <br /> TOTAL DUE this Billing Period: _$128. 50 <br /> Please make Checks PAYABLE to : PHS/EHD <br /> PAYMENT <br /> JUN <br /> NUN 2819M <br /> WIN Wl.;NTY <br /> A143L!C Y` ,-4 5'--ACES <br /> EaYlei0i:rdE,y ii L HEALI H DIVISION <br />