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SAN JOAOUIN COUNTY PUBLIC iLTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E WEBER AVE-3RD FLOOR ,�SID <br /> D <br /> STOCKTON. CA 95202 er <br /> 209-468-3420 R G <br /> 2001 <br /> INVOICEAR0002ss2 <br /> Account ID <br /> pROQFA0003118 <br /> Facility ID <br /> Date Printed 1/31/01 <br /> RE : LONGS DRUG STORE#492 <br /> LONGS DRUG STORE#492 1122 W 11TH ST <br /> PO BOX 5010 TRACY CA 95376 <br /> ANTIOCH CA 945315010 OWNER: LONGS DRUG STORES,INC <br /> Health <br /> Date Program Descriptioii Hrs Employee Amount <br /> Invoice# IN0079266---Date of Invoice: 1/30/01 <br /> 1/30/2001 2220 SM HW G N<5 TONSNR $100.00 <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice 00 <br /> Payment Due Date 3M200 <br /> TOTAL DUE this Billing Periodl 4110.0 <br /> Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be addic d to all Permit Fees For all SERVICE FEES <br /> at the Rate of 1001 0 of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after he Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> RECEj�D <br /> N JOAO�4''N C�VICFS <br /> SA 41(1111'1 �101 SQN <br /> ENVPR Nh_f.iSAl. <br /> 5255.rpt <br />