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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVT.RONMENTAL HEALTH DIVI^''ON <br />304 E WEBER AVENUE — 3RD BOOR <br />PO BOX 388 <br />STOCKTON, CA 95201-0388 <br />Accounting Office: 209 468-3420 <br />=nvc).i.c*-- <br />TO: THREE PALMS GROCERY <br />2891 N ARATA RD <br />STOCKTON, CA 95205 <br />ATTN: BOZZANO, LINO <br />RE: THREE PALMS GROCERY <br />6732 E HWY 88 STOCKTON <br />Report #5255 <br />St ement Printed: 02/05/96 <br />PLEASE RETURN a COPY of THIS STRTEIMT with YOUR PAYNENT <br />Account # 0003669 <br />Facility ID 004030 <br />ar— <br />Service Activity <br />Date Description Hrs Employee Amount <br />Invoice # 026478 -- Date of Invoice: <br />02/05/96 2301 UST State Surcharge Fee <br />If this INVOICE has been Paid, Please Oisregard this Notice . . . <br />PENALTIES will be ASSESSED on all ANNUAL PERMITS <br />at the rate of lilt of the Base Fee <br />31 days after the Payment DUE DATE. <br />02/05/96 <br />Tank # TA183OO2 $56.00 <br />-------------------------- ----- <br />Total for this invoice: $56.00 <br />Payment DUE DATE 03/06/9 <br />PAYMENT <br />FEB 13 1996 <br />SAN JOAOUIJCOUN,•; <br />PUBLIC HEALTH SERVICES- <br />- — LNViP-1M Anc.—. <br />PENALTIES for all FEES for SERVICE will be ASSESSED <br />at the rate of lit of the Service Fee <br />30 days after the Payment DUE DATE <br />and EACH 30 days thereafter. <br />TOTAL DUE this Billing Period: 56.00 <br />AccountI 1-30 Days 131-60 Days ' 61-90 Days 191-120 Days' 121+ plus <br />Summary <br />5 5 5 <br />