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i Report 35255 - <br /> tN J0AQtJ.1N COUNTY R, UBLI`�=�.�Al»T�t SERVICES �4 S mei1� ' Printedc 04 {23 {97 <br /> r4VIRONMENTAL HEALTH DIVI <br /> X104 E WEBEP. AVE <br /> t€l!E 3RD r <br /> TOCKTON , CA 95264 <br /> ccounting Office : 269 468-342Q <br /> TO : SErCOR ( Account # 0011.176 <br /> 25864 BUSINESS CENTER DR STE F <br /> REQLAtdDS , CA 92374--4515 <br /> FFii'ty ID 007417ATTN : NADEEM 5ROVE _ <br /> i <br /> I RE : ARCO #YWOP <br /> i 1100 S hAIN ST MANTE:CA E <br /> PLEASE RETURN a COPY of THIS STATEAEHT with PUP PAM14T <br /> Hrsil EwmpIOYee Amount <br /> Date Description <br /> Invoice # @35034 Date of Invoice : 11/08/96 $-2D <br /> i 4 . 00 <br /> 11 /07 /96 PAYMENT1�M 5 INFURNA $163 .80 11 /67 /96 2950 REMPORT REVIEW 2441 INFURNA $163 .80 <br /> r 11/21 /96 2950 FIELD CONSULT 2t"pINFURNA $31 'Zt <br /> 4 13 /27 /46 2950 CONSULTATIONOi. 3 INFURNA $23 . 40 <br /> a 1.2/02 /96 2950 CONSULTATION $-85 . 80 <br /> 02/04 /97 PAYMENT ' $-109 . 20 <br /> 03/05/97 PAYMENT 0 . 3 INFUF?NA $'23 ° 40 <br /> 03/1.2 /97 2950 REPORT REVIEW 7�. 0 INFURNA $546 . 00 <br /> 03/13/97 2950 REPORT REVIEW $23 . 40 IN $23 . 40 <br /> 03/21 /97 2950 C0h4SULTATION . $374 . 40 <br /> 41. 8 1NFURNA <br /> 03/25 /97 2950 FIELD CONSULT _ 'i ----_--_—__..__—___—____------- <br /> Total for this invoice : $881 . 40 <br /> iPayment DUE DATE_ r 05/2x /37 <br /> ti L <br /> If this INVOICE has been Paid, Please Disregard this Native <br /> 074 <br /> �ivr L�r /�Tt1 <br /> II PENALTIES for all FEES for SERVICE will be ASSESSED <br /> 4 PENALTIES will be Az"SESSEO on all ANNUA( PERMIT Fe liat the rate of 10% of the Service Fee <br /> l at the rate of 1004 of the Base Fee 30 days after the .Payment DUE DATE <br /> 30 days after the Payment DUE DATE. i� and EACH 30 days thereafter. <br /> 4 TOTAL DUE this q:illing Period : <br /> Please Make CHECKS PAYABLE tof1 F:1' ;1-11 :E::; <br />