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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report 15255 <br /> ENVIRCINMENTAL HEALTH DIVT ON St*ment Printed : 01 /29/99 <br /> 30.4 E WEBER AVENUE — 3RD OOR <br /> STOCKTON , CA 95202 <br /> Accounting Office : 209 468-3420 <br /> TO : <br /> <br /> <br /> ATTN : SHARON WATSON Facility ID 004033 <br /> RE : CIRCLE K STORES INC #5449" <br /> 7647 PACIFIC AVE <br /> STOCKTON <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity <br /> Date Description Hrs Employee Amount <br /> Invoice # 054257 -- Date of Invoice : 01/28/99 <br /> 01 /28/99 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10 . 00 <br /> 01/28/99 2360 UST Permit Fee Tank # TA505679 $170 . 00 <br /> 01 /28/99 2360 UST Permit Fee Tank # TA505681 $170 . 00 <br /> 01/28/99 2360 UST Permit Fee Tank # TA505680 $17 0 <br /> Total for this invoice : 5520 .00 <br /> Payment DUE DATE 03/01/ <br /> If this INVOICE has been Paid, Please Disregard this Notice <br /> -.max-aaxe,-. <br /> PAYMENT <br /> I sliRJ <br /> 6 '1999 <br /> *-:VIAI COUNTY <br /> iE4l:fH SERVICES <br /> .u.mr N1AL i1EALTH DIVISION <br /> For all SERVICE FEES penalties will <br /> Penalties will be added on all Permits be added at the rate of 118 61 days <br /> at the rate of 1198 of the Base Fee 31 past invoice date and each 39 days <br /> days after the due date. thereafter. <br /> TOTAL DUE this Billing Period: $520.00 <br /> Please make Checks PAYABLE to : PHS/EHD <br />