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SAN JOAQUIN COUNTY PUBIJ ;ALTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209-468-3420 <br /> INVOICE Account ID AR00222 <br /> F �Facility ID A0012658 <br /> Date Printed 10/4/00 <br /> RE : BACK ROADS CUSTOM CYCLE <br /> BACK ROADS CUSTOM CYCLE 7939 W ELEVENTH ST <br /> 1220 RICHARD R TRACY CA 95304 <br /> TRACY CA 9537 <br /> OWNER: TOWNS, DEAN/MARTINEZ,GEORGE <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0076236---Date of Invoice: 10/4/00 <br /> 10/4/2000 2220 SM HW GEN 5 TONS/YR $100.00 <br /> 10/4/2000 2399 UNIFIED PRC GRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $110.00 <br /> Payment Due Date 11/3/2000 <br /> TOTAL DUE this Billing $110.00 <br /> Please make Checks PA ABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Pen atieswi 11 bea e to al I Permit Fees Fora <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> 5255.rpt <br />