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SAN JOAQUIN COUNTY PUBLIC�ALTH SERVICES StaWent PrintedKSPY 12/18/96 <br /> ENVIRONMENTAL HEALTH DIVI N <br /> .3O4'E WEBER AVENUE — 3RD FLOOR <br /> PO BOX 388 <br /> STOCKTON , CA 95201-0388 <br /> Accounting Office : 209 468-3420 <br /> x r-1 . c: <br /> TO : RIPONA MARKET Account # 0000712 <br /> 223 WASHINGTON --- <br /> RIPON , CA 95366 <br /> Facility ID 000713 <br /> ATTN : RIPONA MARKET <br /> RE : RIPONA MARKET <br /> 223 WASHINGTON RIPON <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity Amount <br /> Date Description <br /> Date <br /> Employee <br /> Invoice # 034352 -- Date of Invoice : 12/17/96Tank # TA257601 $170.00 <br /> 12/17/96 2380 UST Permit Fee Tank # TA267602 $1 00 <br /> 12/17 /96 2380 UST Permit Fee ------------------------- ----- <br /> Total for this invoice: $340.0 <br /> Payment DUE DATE 01/18/97 <br /> If this INVOICE has been Paid, Please Disregard this Notice . . . <br /> r-PA'InAEdN-J <br /> 0 $:CEIVFFF : <br /> JAN 91997 <br /> SAN JCAOUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PENALTIES for all FEES for SERVICE will be ASSESSED <br /> at the rate of It% of the Service Fee <br /> PENALTIES will be ASSESSED on all ANNUAL PERMIT Fe 31 days after the Payment DUE DATE <br /> at the rate of 111E of the Base Fee and EACH 31 days thereafter. <br /> 31 days after the Payment DUE DATE. ---- <br /> TOTAL DUE this Billing Period: $340 . 00 <br /> Please Make CHECKS PAYABLE to: 0=' 1"1 "..; P° Rr A 1 LA <br /> $340 . 00 <br /> 0 to 31 days 31 to 60 daps 61 to 90 days 91 to 120 days ) 121 days Account <br /> Balance <br /> i � <br />