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UAOUIN <br /> 1041vv <br /> V_�RON <br /> El:: MENT COUNTY PUBLIC :ACTH SERVICES <br /> AL HEALTH DIV�gON <br /> E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 Iwo Page 1 <br /> 209-468-3420 <br /> INVOICE <br /> Account lD AR0017813 <br /> Facility ID FAO-010813 <br /> GURJIT BASSI Date Printed 2/1/01 <br /> G&S TRUCK WASH RIPON <br /> RE : G&S TRUCK WASH RIPON <br /> PO BOX 3 816 FRONTAGE RD <br /> RIPON CA 95366 RIPON CA 95366 20 <br /> OWNER : GURJIT BASSI <br /> Health <br /> Date Pro "m Descripi'un <br /> Invoice# IN0080978--Date of Invoice: 1/30/01 —._.__.._Hrs Employee <br /> -- —_— Amount <br /> 1/30/2001 2220 SM HVV GEN c5 TONS/YR <br /> 1/30/2o01 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE <br /> $100.00 <br /> $10.00 <br /> Totalforthis Invoice $110.00 <br /> Payment Due Date 3/3/2001 <br /> TOTAL DUE this Billing Period $110.00 <br /> Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees <br /> at the Rate of 100%of the Base Fee For all SERVICE FEES <br /> Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date andeach 30 thereafter <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 12001 <br /> SAN j'IN COUNTY <br /> PUB ICOAQLHEEAQH SERVICES <br /> ENVIRONWMAL HEALTH DIVISION <br /> 5255.rpt <br />