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JAN JUAUUIN LUUN17 <br /> ENVIRONMENTAL HEALTH DEPARTMF"T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR _ <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0016473 <br /> Facility ID F FA0009473 <br /> sl�4 Date Printed 4/20/2005 <br /> lumommmmmmmommomm <br /> LODI PUBLIC WORKS RE : LODI PUBLIC WORKS <br /> PO BOX 3006 210 W ELM ST <br /> LODI, CA 95241-1910 LODI, CA 95240 <br /> OWNER : CITY OF LODI <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN01 29147--Date of Invoice : 1/24/2005 11111IIHIT 111111111111111111111IIIIIAVIIIVIIIVIIIV1111111111111VIIIIN111I <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 100.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> 3/15/2005 9987 Haz Mat Program Penalty Fee $ 10.00 <br /> Total forthis Invoicel $ 134.00 <br /> Payment Due Date 2/2312005 <br /> TOTAL DUE this Billing Period $ 134.00 <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 OES/HMMP 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 /> 5255 rpt <br />