Laserfiche WebLink
SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report #5255 <br /> ENVIRONMENTAL HEALTH D. S ON meat Printed : 04/29/96 <br /> 304 E `WEBER AVENUE — 3 F AOR <br /> 'PO BOX 33$ <br /> STOCKTON , CA 95201-03$$ <br /> Accounting Office 209 468 -3420 <br /> TO : LODI HEALTH CARE CENTER <br /> 1120 SYLVIA DR Account 2' <br /> LODI , CA 95240' <br /> ATTN : LOCI HEALTH CARE CENTER '° Facility ID 2 <br /> RE . LODI HEALTH CARE CENTER <br /> 1 .20 SYLVIA DR LODI <br /> PLEASE RETURN a-COPY of THIS STATEMENT with YOUR PAYN'ENT <br /> Service Activity , <br /> "Date Description Hrs Employee Amount <br /> Invoice # 025009 -- Date of Invoice : 12/29/95 <br /> 12/19/95 4524: SKILLED 'NURSINC FACILITY HEALTH PERMIT $350 . 00' <br /> 02/1$/96 Penalty $350 . 00 <br /> ------------------------------------- <br /> Totael for this invoice: _ $700.' 00 <br /> Payment PAST DUE <br /> If this INVOICE has been Paid, Please Disregard this Notice <br /> PENALTIES for all FEES for SERVICE will be ASSESSED <br /> PENALTIES will be ASSESSED on all :ANNUAL PERMITS at the rate of 11% of the Service Fee <br /> at the rate of 169% of the Base Fee 39 days after the Payment DUE DATE <br /> 30 days after the Payment' DUE DATE and EACH 39 days thereafter. <br /> TOTAL DUE' hi illin Period: A <br /> Account 3 _30 Gays 33 60 Dye 61-90 Days F33 120 Days 121 Plus <br /> Summary <br /> Oa0E9 0 :00 OaOO �OOaOO r OaOO <br />