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SAN.IOAOIIIN COIiNTV PIJBLIC UE,ALTH SERVICES Page 1 <br /> ENVIRONMENTAL Hf AI,'v'. Df ON <br /> 304 F,WEBER AVE,-3RD FLOOR <br /> STOCKTON_ CA 95202 <br /> 209-468-3420 <br /> INVOICE Account ID AR0001347 <br /> Facility ID FA0001349 <br /> Date Printed 2/28/01 <br /> RE : ARCO AM/PM MINI MART <br /> ARCO AM/PM MINI MART 130 S WILSON WY <br /> 130 S WILSON WAY STOCKTON CA 95205 <br /> STOCKTON CA 95206 <br /> OWNER : w7CHT C0-! LLN' <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0081931 —Date of Invoice: 2/27/01 <br /> 1/17/2001 2546 444 COMPLAINT INSPECTION 2.0 KITH $174.00 <br /> 1/17/2001 2547 944 OT COMPLAINT 5.5 KITH $717.75 <br /> 1/17/2001 2546 444 COMPLAINT INSPECTION 2.5 BRIGGS $217.50 <br /> 1/18/2001 2546 444 COMPLAINT INSPECTION 5.0 KITH $435.00 <br /> 1/18/2001 2547 944 OT COMPLAINT 8.5 KITH $1,109.25 <br /> 1/19/2001 2546 444 COMPLAINT INSPECTION 1.5 KITH $130.50 <br /> Total for this Invoice $2,784.00 <br /> Payment Due Date 3/30/2001 <br /> TOTAL DUE this Billing Period $2,784.00 <br /> Please make Checks PAYABLE to : PHS/EHD / Return a Cony of Thi,STATFMFNT wirti Y„1.n A"!V%jT <br /> Penalties will be added to all Permit Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> COTT L. NURDOCK <br /> MAR 5 2001 <br /> NOTED <br /> RI-TURN CHECK PAYMENT <br /> RECEIVED <br /> MAR 2 3 2001 <br /> \ \ SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIROIJMENIAL HEALTH DIVISION <br /> 5255.rpt <br />