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Dh' JUMYU1N k UUN 1 Y FUbLIG HEALTH SERVICES I Report #5155 <br /> ENVIRONMENTAL ,HEALTH DIV - ON .St', 4ement Printed : 14/21/96 <br /> 34 E-lJEE3EFt AVENUE - 3RDpOR ' s <br /> ?ei1 'S 3 8 8 <br /> STOCKTON , CA 95201-0388 "-j it <br /> Accounting Officer 209 468-3420 <br /> I <br /> 3 . <br /> r TO : UNION TCE:/DONS DISTRIBUTION_ <br /> 6104 SHEILA ST ::Account i# @@03677 <br /> LOS ANGELES , CA 90040-2447 <br /> ATTN : BRETT LARSON Facility ID 004036 <br /> 3 <br /> RE : UNION ICE/DONS DISTRIBUTION <br /> �-- - 13-2 0 = LJ W-Ef3 E:R... ._S T-0 C h:T O-N <br /> i <br /> _ r <br /> r PLEASE RETURN a COPY of THIS STATEIiENT with YDUR PAY�Ei1T <br /> k _' F --.•-.- - _ <br /> Service As'tivity ` <br /> Date Description Hrs C E�ployee Amount <br /> T <br /> Invoice # 027885 - Date of Invoice : 05/16/96 1 <br /> 04/15/96 2960 INTRAGENCY LIAISON 4 , MEAYS $31 . 20 <br /> 04 /17/96 2960 REPORT REVIEW 0 . I ME�AYS $39 . 00 <br /> 06/11. /96 PAYMENT $- 70 . 20 , i <br /> i09/11/96 2960 REPORT REVIEW 0 -3 MEAYS $23 . 40 <br /> _ Total for this .invoice: X23.40 <br /> Payment DUE DATE 17/9 <br /> If this INVOICE has been Paid, Please Disregard this Notice I <br /> I <br /> I <br /> i <br /> _ PAYMENT <br /> I ��1...••:._.a 5-�...:.y <br /> NOV 211996 � <br /> ' SAN,O."N'O N CQUi\1T4 1 <br /> PP�LIBB,IIC HEALTH SERVICES <br /> -PENALTIES for alJFEES a 15tT�Vi' wiifLbeE S SSE �fISiUti <br /> PENALTIES will be ASSESSED on all ANNUAL PERMIT Fe at the rate of 10% of the Service Fee 1 <br />{ at the rate of 100% of the Base Fee 3� days efter the Payment DUE HATE { <br /> 30 days after the Payment DUE DATE. ;, I and EACH 38 days thereafter, <br /> TOTAL DUE this Billin Period : <br /> =$23 -40 <br /> Please Make CHECKS PAYABLE_ to: IF71 II N :;::a; II'.::: IF••il If.:31 <br /> - $23 . 44 $0 . 04 $0 . 00 =$L3I00 $0 . 40 <br /> :�1123 . 40 <br /> Balan0Oeto 36 days 31 to 60 days 61 to 90 days 91 to 120 days ) 120 days Account <br /> I � <br /> _ I � <br /> , <br />