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34 E 20ESER y'n' rn DIVISION <br /> PO BOX 388 AVENUE` _ 3RD FLOOR Report #5255 <br /> ' Statement Printed : <br /> CA 95201-0388 I <br /> STOCKTON, 08121195 <br /> Accounting Office : 209 468-3420 <br /> I <br /> I I <br /> r a 'w,. ca <br /> I c'� <br /> I <br /> TO : TRACY <br /> <br /> --- '------- <br /> Account # 0002873 <br /> ATTN : TRACY GOLF & COUNTRY CLUB <br /> _ice__ <br /> RE : TRACY GOLF Facility ID 003299 <br /> 35000 S CHRISMANfaTTR CLUB <br /> _ - _ TRACY <br /> _PLEASE RETURNa COPY of THIS STATEMENT with YOUR PAYMENT <br /> [Date Dese <br /> cription Service Activity <br /> rs <br /> Employee <br /> -_--,-. A m o u n t <br /> Invoice # 021627 -- Date of Invoice: <br /> 06/13/95 PAYMENT 06/15/95 <br /> 06/14/95 2380 UST PERM CLOSURE PLAN CHCK/IN 1 . 0 FOLEY <br /> 07/07/95 238 $78 ©® <br /> .0 UST PERM CLOSURE PLN CHCK/INS 1 . 0 FOLEY $-234 . 00 <br /> 07/10/95 2380 UST PERM CLOSURE PLN CHCK/INS 2 .5 FOLEY <br /> $78 . 0p <br /> ------------___ $195 . 00 <br /> Total for this invoice: <br /> Payment DUE DATE : 117 . 00 <br /> If this IRVOICE has been Paid, Please Disregard this Notice . . . 07/15/9 <br /> r. <br /> PAYMEPAI'i <br /> SEP 2 01995 <br /> SAN JOAQUq•.I,^ <br /> PUBLIC HEALTHERVI I i <br /> ENVISERVIRON MENTAL CES <br /> HEALTH DIVISION <br /> PENALTIES for all FEES for SERVICE will be ASSESSED <br /> PENALTIES will be ASSESSED on all ANNUAL PERMITS at the rate of 11% of the Service Fee <br /> at the rate of 100E of the Base Fee 30 days after the Payment DUE DATE <br /> 30 days after the Payment DUE DATE. and EACH 30 days thereafter. <br /> TOTAL DUE this Billing Period : 5117 .00 <br /> Account 1-30 Days 31160 Days 61-90 Days 191-120 Days 121+ Plus 1 <br /> S u m m.3 r-y <br /> 273 . 00 0 . 00 -156 . 00 0 . 00 0 . 00 <br />