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SAN, JOAQUIN COUNT`( PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISI�[4 <br />9'04 E W�gER .AVEN JEs — 3RD F.R <br />PO BOX ' EIB <br />STOCKTON, CA 9520 —0386 rh <br />Accounting Office: 209 468-3420e <br />TOI MANTECA, CITY OF <br />1001 W CENTER yr, <br />MANTECA, CA 95337 <br />RE <br />CITY OF MANTECA <br />210 E WETMORE AVE MANTECA <br />aepa <br />__StatWnt Printed`l2/ <br />.. 18/96 <br />Account # 0003432 <br />Facility ID 003844 <br />PLEASE RETURN a COPY of THIS STATENEIIT with -YOUR PAYMENT _ <br />Service Activity <br />Date Description H r s Employee Amount <br />Invoice # 034582 -- Date of Invoice: <br />7.2/17/96 2380 UST Permit Fee <br />12/17/96 2380 UST Permit Fee <br />12/17/96 2380 UST Permit Fee <br />If this INVOICE has been Paid, Please Disregard this Notice . . . <br />12/17/96 <br />Tank # TA145001 $170.00 <br />Tank # TA145002 $170.00 <br />Tank # TA145003 $170.00 <br />---------- <br />Total for this $510.00 <br />PaymementntD—DUE---DATE— <br />PAYMEN'T <br />,rvP. <br />JAN 211997 <br />SAN JOAOUIN COUNTY <br />PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />PENALTIES for all FEES for SERVICE will be ASSESSED <br />PENALTIES will be ASSESSED on all ANNUAL PERMIT Fe at the rate of 10% of the Service Fee <br />30 days after the Payment DUE DATE <br />at the rate of 1001 of the Base Fee <br />and EACH 30 days thereafter, <br />30 days after the Payment DDE DATE. — <br />TOTAL DUE this Billing Period: $510 <br />Please Make CHECKS PAYABLE to: <br />d Acce <br />0 to 30 days 31 to 60 days <br />Balance <br />61 to 90 days 91 to 120 days ) 120 ays <br />0 <br />