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S1 JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report #5255 <br /> E IR1*NMENTAL HEALTH DIVISION Statement Printed : 05/17/96 <br /> '304 E WEBER AVENUE – 3RD DOR <br /> PO BOX 388 <br /> STOCKTON , CA 95201-0388 <br /> Accounting Office : 209 468-3420 <br /> .. 1``r c► l.. : e e <br /> t TO : UNIO ICE /DONS DISTRIBUTION — -- <br /> 6100 SHEILA ST Account # 0003677 _ <br /> LOS ANGELES , CA 90040- 2407 <br /> ATTN : BRETT LARSON Facility ID OO4O36Y <br /> RE ; UNION ICE /DONS DISTRIBUTION <br /> 1320 W WEBER STOCKTON <br /> PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT v � � <br /> Service Activity <br /> Date Description H r s Employee Amount <br /> Invoice 0 027885 -- Date of Invoice : 05/16/96 <br /> 04 /15/96 2960 INTRAGENCY LIAISON 0 . 4 MEAYS $31 . 20 <br /> 04 /17/96 2960 REPORT REVIEW 0 . 5 MEAYS $39 . <br /> Total for this invoice : $70 . 20 <br /> Payment DUE DATE 06/16/ <br /> If this INVOICE has been Paid, Please Disregard this Notice . . . <br />-I <br /> i PENALTIES for all FEES for SERVICE will be ASSESSED <br /> PENALTIES will be ASSESSED on all ANNUAL PERMITS at the rate of 10% of the Service Fee <br /> at the rate of 1008 of the Base Fee 30 days after the Payment DUE DATE <br /> 3e days after the Payment DUE DATE. and EACH 30 days thereafter. <br /> TOTAL DUE this Billing• Period : $70 .20 <br /> Account 1-30 Da 31-60 Days 61--90 DayJ--9 <br /> y 1.-120 Days 121+ Plus <br /> umma r _ <br /> 70 . 20 0 . 00 0 . 00 0 . 00 0 . 043 <br />