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3 Y <br /> SAN JOAQUIN COUNTY Page 1 <br /> ENVI'RON'MENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> INVOICE Account lD FAR0030097 <br /> LUMEMMMMMENNIIII <br /> FaGrM1y ID FA001 7-21-5— <br /> LMEMEMMMMMEMME <br /> Date Printed 1/30/2014 <br /> COOPER OUT WEST RE : COOPER OUT WEST <br /> 16636 E MILTON RD 11711 E EIGHT MILE RD <br /> LINDEN, CA 95236 STOCKTON, CA 95212 <br /> OWNER: COOPER OUT WEST <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0249580—Data of invoice: 1/3012014 111111111111111111111111 IN <br /> 1/30/2014 1958 HM-Farm Operations $ 18.00 <br /> 1/30/2014 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 1/30/2014 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Invoice $ 266.00 <br /> Payment Due Data 31112014 <br /> TOTAL DUE this Billing Period $ 266.00 <br /> Please make Checks PAYABLE to: 'EHD' – Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For HMBP Fees For all SERVICE FEES <br /> 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 />