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SAJOAQUIN COUNTY PUBLIC LTH SERVICES <br />w€Nt1RQNMEeNTAL HEALTFO DIVISS Sta nt <br />304 t'gEI6ER AVENUE -= 3RD FLOOR <br />PO BOX 388 ' <br />STOCKTON, CA 95201-0388 W11� <br />Accounting Office: 209 468-3420 1 `I <br />Report #5255 <br />Printed: 02/05/96 <br />Obi-Crl� <br />TO: MANTECA, CITY OF <br />1001 'W CENTER Accouunt # 0003432 <br />+MANTECA, CA 95336 <br />Facility IO 003844 <br />RE: CITY OF MANTECA <br />210 E WETMORE AVE MANTECA <br />PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT__ <br />Service Activity <br />Date Description Hrs Employee Amount <br />invoice # 026416 -- Date of Invoice: <br />02/05/96 2301 UST State Surcharge Fee <br />02/05/96 2301 UST State Surcharge Fee <br />02/05/96 2301 UST State Surcharge Fee <br />If this INVOICE has been -pit . flease Disregard this Notice . . . <br />W <br />PENALTIES will be ASSESSED on all ANNUAL PERMITS <br />at the rate of 100E of the Base Fee <br />30 days after the Payment DUE DATE.,' <br />AccountE 1_30 Days <br />Summary <br />678.00 <br />02/05/96 <br />Tank # TA1450O1 $56.00 <br />Tank # TA14,5002 $56.00 <br />Tank # TA145003 $56.. <br />Total for this invoice:(!03/0:6/9 <br />6.00 <br />Payment DUE DATE <br />PAYMENT <br />RECEIVED <br />MAR 91996 <br />SAN AQUIN COUNTY <br />PUtLICOHEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />PENALTIES for all FEES for SERVICE will be ASSESSED <br />at the rate of lot of the Service Fee <br />30 days after the Payment DUE DATE <br />and EACH 3days thereafter. <br />TOTAL DUE this Billing Period: $168.00 <br />31-60 Days <br />0.00 <br />61-90 Days <br />0.00 <br />0 <br />91-120 Days <br />0.00 <br />121+ Plus <br />M <br />