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SAS! JOAQUIN COUNTY PUBLIC 1-4LTH SERVICES —.�. r Report 15255 <br /> ENVIRONMENTAL HEALTH DIVISt,,,,4 + � StaV, nt Printed : 10. 21/99 <br /> 3O4 E WEBER AVENUE — 3RD FLj5OR Y <br /> STOCKTON . CA 95202 <br /> Accounting Office : 209 468-3420 <br /> AL <br /> ij <br /> t <br /> TO : COSTAMAGNA , ' ERNEST <br /> PO BOX 262 Account # 0003700 i <br /> BANTA , CA 95304 <br /> ATTN : ERNEST COSTAMAGNA ' Facility ID 00+4052 <br /> RE : FARM UGT <br /> 18775 S TOM PAINE RD t <br /> TRACY <br /> d <br /> PLEASE RETURN a COPY of THIS STATERENT with YOUR PAYMENT <br /> Service Activity sI <br /> Date Description Hrs, Employee Amou{ht , <br /> ;w <br /> Invoice # 065090 -- Date of Invoice : 10/20/99 <br /> 09/03/99 2951 REPORT REVIEW 1 . 1 INFURNA $85 . 80 <br /> 09/29/99 2951 FIELD CONSULT 5 . 1 INFURNA $$97 . 80 <br /> 10/20/99 2951 REPORT REVIEW 1 . 9 INFURNA $148 . 20 <br /> �1 <br /> - ----__-__ <br /> 5 ----_ <br /> Total for this invoice : $631.80 <br /> Payment DUE DATE 11�J21/99 <br /> If this INVOICE has been Paid, Please Disregard this Notice <br /> 4 <br /> For all SERVICE FEES penalties will <br /> Penalties will be added on all Permits be added at the rate of 10% 61 days <br /> at the rate of 100% of the Base Fee 30 past invoice date and each 30 days €� <br /> days after the due date. thereafter. <br /> TOTAL DUE this Billing Period : $531 .80 <br /> Please make Checks PAYABLE to : PHS/EHD <br /> f <br /> f <br /> i . <br /> - d <br />