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SAN JOAQUIN COUNTY PUBLIC Y"4,LTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIV, ,N <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON <br /> <br /> AR0017975 <br /> Facility ID FA0010975 <br /> Date Printed 4/25/00 <br /> KM BOWLES/RISK M MT RE: KRAGEN AUTO PARTS#1482 <br /> KRAGEN AUTO PARS 309 W CHARTER WAY <br /> PO BOX 6030 <br /> PHOENIX AZ 85005 OWNER: CSK AUTO INC <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0071357—Date of Invoice : 4/19/00 <br /> 4/19/2000 2220 SM HW GEN<5 TONSNR $100.00 <br /> 4/19/2000 2399 UNIFIED PF OGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $110.00 <br /> Payment Due Date 5/2511200 <br /> TOTAL DUE this Billing Period $110.00 <br /> Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For all SERVICE FEES <br /> at the Rate of 1000of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after die Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> NA►Y 2100 <br /> SAN JOAQUIN COON I <br /> pUBUC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 5255.rpt <br />