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02/26/2004 16: 36 4640138 ENVIRONMENTAL HEALTH PAGE 11 <br /> 'AN JOAQUIN COUNTY 5 Page 1 <br /> :NVIRONMFwNTAL HEALTH DEPARTMEN <br /> 104 E WEBER AVE -3RD FLOOR <br /> ,TOCKTON, CA 95202 RECEIVED <br /> 'hone: (209)468-3420 <br /> INVOICE FEB 27 2004 Account 10 AR0001993 <br /> FRICE OFEMERGENCY SERVICE FncllltyID FA0001886 <br /> Dale Pdmed 2/512004 <br /> CON14 <br /> KFC HARMAN- RE : KENTUCKY FRIED CHICKEN#206 <br /> 3264 W HAMMER LN 3264 W HAMMER LN <br /> STOCKTON, CA 95209 STOCKTON UT 95210 <br /> ION/L'y <br /> OWNER INC <br /> Date Health Amount <br /> Program Description <br /> Involce IF IN0117326-^Date of Invoice: 214/2004 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 255.00 <br /> 2/42004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> rotel for this Invoice $ 279.00 <br /> Payment Due Date 31612004 <br /> TOTAL DUE this Billing Period $ 279.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 4 2004 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHD' - Return a Copy of This STATEMENT with Your PAYMENT <br /> For all SERVICE FEE$ <br /> alties will <br /> Penaklea will be added to all Permit Fees Fer OES/ at Fees the Rate of 10%, Penalties will he added at the Rate of 10% <br /> a added <br /> at the Rata of 100%of the Base Fee Pen <br /> 30 Days after the Due Pete 45 Days afterr the <br /> he innvoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br />