Laserfiche WebLink
•iIE;L.lc HEALTH SERVICES <br /> ay 'r ., • S flN TOAQUIM COUNTY <br /> in St. . , P .U . Box.. X009 <br /> .. dci5 N . TMIauQ,. Ca 95201 <br /> t209) 46g-0340 <br /> NIPERMCLO <br /> NIRIVE;23 <br /> Site Information; � <br /> RIVER':IDE CEMENT Co . <br /> RIVERSIDE CEMENT CO . 2825 W WASHINGTON <br /> ;fig^5 W WASHINGTON STOCKTON, CA <br /> L 9S2031 <br /> TOCKTON , CA <br /> f <br /> 23, 13y de OVERTIME REVIEW CLOSURE FLAN UGST 10/23/9*: <br /> services were Provided or you by the Environment! Health Divisio : <br /> i is t•ober <br /> 09 Ti TAL DUE ; <br /> Invoice Date : OCTOBER <br /> � --- <br /> 10% penalty will be added each <br /> 30 days past invoice date . <br /> RETURN PAYMENT ALONG WITH ONE NE Copy OF <br /> PLEASE REPORT CHANGES 1N THE "THIS STATEMENT TO: <br /> SPACE PROVIDED BELOW WITHIN Soaquit- <br /> 1S DAYS OF THE. DATE OF THISPublic Health =services, _pan <br /> INVOICE . IF NOTIFICATION IS Count&Environmental Health <br /> NOT RECEIVED WITHIN THAT TIME P . U . Box 2009, Stockton, Ca 95201 <br /> PERIOD, THE PARTY IDENTIFIED <br /> ABOVE WILL BE LEGALLY RESPON- <br /> SIBLE FOR i'Hi:3 BILL . <br /> _ . <br /> IF THE ABOVE BILLING ADORED::• I'=� NOT CORRECT , PLEASE INDICATE BELOW:------------------ <br /> �------- <br /> NAME:---•--------- <br /> ----------------- <br /> ----------_ <br /> ADDRESS ------ _ --- <br /> ---------- zip <br /> CITY ,TATE <br /> `4 <br />