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'$AIVJUAUUIN GUUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMF"IT Page 1 i <br /> 600 E MAIN STREET # <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0000639 <br /> Facility ID FA0000640 <br /> t <br />�. Date Printed 11/20/2008 I <br /> t- , <br /> HUGO VAN VLIET RE : A-1 SEPTIC SERVICE <br /> A-1 SEPTIC SERVICE 6613 WOODLAND AVE <br />{ 6613 WOODLAND AVE -MODESTO, CA 95358-8502 <br /> MODESTO, CA 95358-8502 <br /> OWNER : VAN VLIET, HUGO <br /> S <br /> I <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0181339--Date of Invoice: 11/1912008 <br /> I IIIIIII IIIIII IIIIIIII IIIIIIIIII IIIIIfIIII IIIII IIIII IIIIIIIIfI IIII IIIIfIlllll IIlIIIII <br /> 11/19/2008 4244 PUMPER TRUCK $ 150.00 <br /> is <br /> I Total for this Invoice $ 150.00 <br /> Payment Due Date 12/20/2008 <br /> TOTAL DUE this Billing Period $ 150: 0 i <br /> is <br /> .i <br /> DEC 2 3 <br /> x C01*V <br /> OA0QIllt�1 <br /> $A F14VIFt �� YMENT i <br /> Hepa_tK p PA <br /> r <br /> 1 <br /> f <br />{ <br />�. Please make Checks PAYABLE to: 'EHD' - Return a Copy of This STATEMENT with Your PAYMENT I <br /> Penalties will be added to all Permit Fees For OES 1 HMMP Fees For all SERVICE FEES <br /> I' at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 45 Days after the Invoice Date . 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />