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,JOAQUIN COUN'T'Y PUBLIC IIF,101-1 SERVICES • Page 1 <br /> ENVIRONMF,NTAL HEALTII DIVISI(1 <br /> '304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209-468-3420 e <br /> �N V O I C E Account lD AR0020046 it <br /> Facility ID FA0012304 <br /> Date Printed 5/25100 <br /> ALFONSO JIMENEZ RE : EL DORADO AUTO <br /> EL DORADO AUTO 2070 S EL DORADO ST <br /> 2070 S EL DORADO STOCKTON CA 95206 <br /> STOCKTON CA 95206 OWNER: JIMENEZ,ALFONSO <br /> Health <br /> His Employee Amount <br /> Dale Program Description <br /> Invoice 0 IN0068352--Date of Invoice: 312100 <br /> 3130/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE r. $10.00 <br /> 31212000 2220 SM HW GEN<5 TONSIYR $100.00 <br /> Total for this invoice $110.00 <br /> Payarenl Due Date 41U20 <br /> TOTAL DUE this Billing Period $110.00 <br /> c <br /> Please make Checks PAYABLE to: ITIS/Eill) / Return a Copy of This STATEMENT with Your PAYMI"NT <br /> EW <br /> ena Ines ret a al r e !o a enrol •ee5 ror a ' • <br /> et the Rale of 100%of lite Base Fee <br /> penalties will he nr/rled at the Rate nl'I!I <br /> 30 Dnrs after the Dae Dale 60 Dari after Ute invoice Date and each..0 thereafter <br /> p,�s,'vfhod'Gr�a ti <br /> jug 1 2zOp® <br /> ,. r. 11 A"UIN <br /> PUeIiC;f!r q�l lz <br /> ENVIRONMENTAL14EAIIn••• "` <br /> 5255.rpl <br />