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SAN JOAOUIN COUNTY PU13LI ALTH SERVICES • Page 1 <br /> ENVIRONMENTAL HEALTH DI SION <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 1 <br /> 209-460-3420 O L <br /> INVOICE \\� vAR0016439 <br /> Account lD <br /> FA0009439 <br /> Facility ID <br /> RECEIVES Date Printed 1131101 <br /> KURT A KEMMER FEB 5 Zoo' RE : AMERICAN TRANSIT MIX <br /> AMERICAN TRANSIT MIX A��OUNTS?AVABI.E 899 E ROTH RD <br /> 318 BEARD AVE FRENCH CAMP CA 95231 20 <br /> MODESTO CA 95354 OWNER: JERRY LARSEN <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0079879--Date of invoice: 1130101 <br /> 1/3012001 2220 SM HW GEN<5 TONSNR $100.00 <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $11 0 <br /> Payment Due Date 1212001 <br /> TOTAL DUE this Billing Period $110.00 <br /> Please make Checks PAYABLE to: PRS/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 /> C) <br /> PAYMENT PAYMENT <br /> REi EIVED <br /> FEB 2 2 2001 <br /> q,,-10UNTY <br /> i avi�rs <br /> H niVISION <br /> 5255.rpt <br />