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• -. �UUIN 1 <br /> r FUdLIC HEALTH SERVICES I <br /> ENV.eONM;NTAL HEALTH DIV, ON Report #5255 <br /> I 445 N SAN JOAQUIN# STREET %we <br /> I PO B:OX 388 <br /> STOCKTON , CA 95201--0388 I <br /> Accounting Office : 209 468--0340 <br /> � I <br /> A r.: c cr LA n t i3 t as t'- r I t: I <br /> I I <br /> I I i <br /> I 70 : SHELL OIL COMPANY INC <br /> H2�I �Ja (flu <br /> I <br /> PO <br /> (I JL} Li,Y3 Account # 0003362 <br /> I <br /> ATTN : HS&E ADMIN SUPPORT — <br /> Facility ID 002111 I <br /> RE : BENJAMIN HOLT SHELL <br /> 3011 W BENJAMIN HOLT DR STOCKTON Billing Date: 01/11/95 I <br /> PLEASE RETURN THIS STATEMENT WITH YOUR PAYMENT <br /> I � I <br /> I Service Activity <br /> Date Description Hrs Employee Amount <br /> I 3 } j <br /> I <br /> I Invoice M 016838 -- Date of Invoice: 01/11/9I6dc� <br /> 01 /11/95 2315 Underground Tank Permit Fee 1�3D� $170 . 00 <br /> 01/11 /95 2315 Underground Tank Permit Fee $170 , 00 <br /> 01/11/95 2315 Underground Tank Permit Fee $170 . 00 <br /> I 01/11 /95 2315 Underground Tank Permit Fee $170 . 00 <br /> -------------------- <br /> ----------------- <br /> Total <br /> ---------------Total for this invoice ; ;680 .00 <br /> If this INVOICE has been Paid , Please Disregard this Notice . <br /> . . . and DEDUCT the Amount Paid from the TOTAL DUE <br /> I <br /> I <br /> Penalties will be added on all PERMIT FEES <br /> at the rate of 100% of the Base Fee <br /> 60 days after the invoice date . <br /> For all SERVICE FEES penalties will <br /> be added at the rate of 10% <br /> 60 days past the invoice date and <br /> each 30 days thereafter . <br /> TOTAL DUE this Billing Period : ;680 .08 <br /> I <br /> Account 1--30 Days 31-60 Days -90 Days 91-120 Days 121+ Plus <br /> Summaryv –^_ <br /> 680 . 00 0 . 00 0 . 00 0 . 00 0 . 00 <br /> i <br /> �I <br />