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SAN JOAQUIN COUNTY PUB HEALTH SERVICES' Pcpot ENVIRONMENTAL HEALTH. DIWr- SION 445 N SAN JOAQUIN PO BOX 2009 STOCKTON, CA 95201 209-468-0340 t EC--�c._ o N-%n t Ea-It E.t E m e n -t Accoi.mt # Date . TO: TIKI LAgJN - - - r--=— 834 FRANCISCO WEST 0001341 +I 1.2/21/9,1 J SAN RAFAEL, CA 94901 �_— —._J!..-_--_:_ H ATTN: HANF, HORST Facility II) RE: TIKI LAGUN PLEASE RETURN THIS STATEMENT WITH YOUR PAYMENT pA YIWE RECEIVED JAN 2 He rlth I Date Program ani Descr ipt ion P SAN Date F F.1 C) n L fNUfb'pNMENTfq y g51HDIW3ION Previous Balance Invoice #000875 -- Date of Invoice: 06/09/93 06/09/93 1616 GROCERY ( 1000 SO FT PERMIT FEE 110. 00 08/01 /93 9999 PAYMENT -110. 041 Tota-1 for this invoice : 0. 00 Invoice #003590 -- Date of Invoice: 08/19/93 08/10/93 5034 UST PERM CLOSURE PLAN )CHECK/TANK INSPECTION 78. 00 " 08/17/93 S034 tIST PERM CLOSURE FLAN CHECK/TANK INSPECTION 2,3. 40 08/19/93 9999 PAYMENT 234. 00 09/08/93 S034 -UST PERM CLOSURE PLAN CHECK/TANK 'INSPECTION 39. 00 09/10/93 S034 UST PERM CLOSURE PLAN CHECK/TANK INSPECTION 39. 00 09/13/93 S034 UST PERM CLOSURE PLAN CHECK/TANK INSPECTION 78. 00 09/16/93 S034 UST PERM CLOSURE PLAN CHECK/TANK INSPECTION 195. 00 09/28/93 -034 UST. PERM CLOSURE Pj-AN_ ,J„I-,ECK/TANK_ INSPECTION 15. 60 11 ,'02/93 3034 UST PERM CLOSURE PLAN CHECK/TANK INSPECTION 78. 00 12/08/9.-3 9999 PAYMENT . -234. 00 Total for this :invoice :-- . 00 PENALTIES on all PERMITS FEES will be assessed at the rate of 100% of the Base Fee amount 60 days after the INVOICE DATE Days o1-60 hays 61-90 Days 91-120 Days 121+ G'11-is Amo1unt Due 78. 00 0. 00 0. 00 0. 00 0. 00 t 78. 00 PENALTIES for all SERVICE FEE billing will be assessed at the rate of 10% of the unpaid Invoice Balance 60 days after, the INVOICE DATE and each 30 days thereafter