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USAN JOAOUIN COUNTY PUBLIC&ALTH SERVICES • Page 1 <br /> ENVIRONMENTAL HEALTH DI ON <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> 209-468-3420 <br /> INVOICE Account ID AR0017090 <br /> FA0010090 <br /> Facility ID <br /> Date Printed 2/1/01 <br /> PATRICK HOLLINGSWORTH RE : AAA MACHINE <br /> AAA MACHINE 121 E LINDSAY ST <br /> PO BOX 997 STOCKTON CA 95202 20 <br /> STOCKTON CA 95201 <br /> OWNER: PATRICK HOLLINGSWORTH <br /> Health <br /> Date Program Description Firs Emp!o ee Amount <br /> � I <br /> Invoice# IN0080384---Date of Invoice: 1/30/01 <br /> 1/30/2001 2220 SM HW GEN<5 TONS/YR $100.00 <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $110.00 <br /> Payment Due Date3/200'I�-31 <br /> TOTAL DUE this Billing Periodl $110. <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 For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> F AYMENT <br /> FEB 2 7 2001 <br /> SAN.iOAC I-'IN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 5255.rpt <br />