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SAP JOAQUIN COUNTY PUBLIC HF� SERVICES Page 1 <br />M <br />ENVIRONMENTAL HEALTH DS <br />304 E WEBER AVE - 3RD FLOOR <br />STOCKTON, CA 95202 <br />209-468-3420 <br />INVOICE Account/ AR0018023 <br />Facility I FA0011023 <br />Date Printed 4/25/00 <br />RE: INTERSTATE TRUCK CTR - COLLISIO <br />KEITH SPRING 641 S HARRISON ST <br />INTERSTATE TRUCK CTR STOCKTON CA 95206 <br />PO BOX 6463 <br />STOCKTON CA 95206 OWNER: JOHN PHILLIPS <br />Health Hrs Employee Amount <br />Date Program Description <br />Invoice # IN0071399 — Date of Invoice : 4119100 <br />-$12.85 <br />4/1512000 9991 Credit Adjustment $100.00 <br />411912000 2220 <br />SM HW GEN 45 TONSNR $10.00 <br />4119/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE Total for this Invoice <br />Payment Due Date 512512000 <br />TOTAL DUE this Billing Period <br />Please make Checks PAYABLE to : PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br />_u ecovrrc cFFC <br />Due <br />5255ryf <br />Penalties will be added at the Rate of 10% <br />60 Days after the Invoice Date and each 30 thereafter <br />MAY S 20 <br />SAN JOAQUIN COk 'y <br />PUBLIC HEALTH St3Mr <br />ENVIRONMENTAL HEALTH -'•dam' <br />