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Report #5255 <br /> , pAQUIN PUBLHEALTH SERVICES <br /> tement Printed : 02/26 /96 <br /> SA(q- COUNTYiON <br /> ENVIRONMENTAL HEALTH DRD FLOOR <br /> 304 E WEBER AVENUE <br /> PO BOX 388 <br /> STOCKTON , CA 95201-0388 <br /> Accounting Office : 209 468-3420 <br /> f e'o cr <br /> Account # 0003424 <br /> TO : 2OCAL FOOD <br /> ESTORE <br /> #1S7 <br /> STOCKTON , CA 95203 Ip 003836 <br /> Facility �_ <br /> ATTN : HAMEEO KHAN <br /> RE : LOCAL FOOD STORE #1 <br /> 2650 MONTE DIABLO ST STOCKTON <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br /> Service Activity Amount <br /> Hrs Employee <br /> Date Description <br /> Date of Invoice: 02/05/96 $56. 00 <br /> e Fee Tank # TA119101 $56 . 00 <br /> Invoice $ 026410 Tank # TA119102 <br /> 02 /05/96 2301 UST State Surcharge $56 . 00 <br /> e Fee TA119103 __ <br /> 02/05/96 2301 UST State Surcharge Fee Tank_#---- — <br /> 02/05/96 2301 UST State Surcharge —______ ^168.00 <br /> Total for this invoice : 03/06/96 <br /> Payment DUE DATE <br /> If this INVOICE has been Paid, Please Disregard this Notice . . . <br /> P64'!`MENll <br /> fiIECF F <br /> MAR - 51996 <br /> SAN JOAQUIN COUN <br /> PUBLIC HEALTH 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 /> PENALTIES will be ASSESSED on all ANNUAL PERMITS 30 days after the Pay®ent Tot once <br /> at the rate of 1808 of the Base Fee and EACH 31 days thereafter. <br /> 30 days after the Payment DUE ORTE, 6168 .01 <br /> TOTAL DUE this Billing Period: <br /> 61-90 Days 91-120 Days 121+ Plus <br /> Account 1-30 Days 31-60 Days <br /> Summary 0 . 00 0 . 00 <br /> e . 00 0 . 0 <br /> 168 . 00 <br /> 0 <br />