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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVIS <br /> v04 E WEBER AVE-3RD FLOOR ` <br /> STOCKTON, CA 95202 <br /> 209468-3420 <br /> INVOICE AccountlD AR0018053 <br /> Facility ID FA0011053 <br /> Date Printed 4/25/00 <br /> CAMILLO (CAM)VALLE RE: CHAMPION <br /> CHAMPION 101, 1220 VANDERBILTCIR <br /> 1301 N EUCLID AVE - <br /> PRINCETON IL 61356 OWNER: GARDNER DENVER INC <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0071423—Date of Invoice: 4/19/00 <br /> SA <br /> 4/19/2000 2220 SM HW GEN<5 TONS/YR I D <br /> $100.00 <br /> 4/19/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $110.00 <br /> Payment Due Date 5/2 000 <br /> TOTAL DUE this Billing Period 110.0 <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 /> r PAYMENT <br /> •i MAY <br /> �� ----- MAY 152008 <br /> SAN JOAOUIN COUNTY <br /> - .- PUBLIC HEAtTH SERVICES <br /> hIVtR0N?oIHNTA!..HEALTH 01VIStON <br /> 5255.rpt <br />