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Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTP 'T <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 RECEiVEJ COPY <br /> Phone: (209)468-3420 <br /> r 2007 Account ID 469 <br /> a �" AR0017 <br /> 4", INVOICE AV JUAUUIIV C:UUN I r <br /> OFFICE OF EMERGENCY SERVICESFA0010469 <br /> Facility ID <br /> Date Printed 1f26J2007 <br /> BANTA CARBONA IRRIGATION DISTR RE : BANTA CARBONA IRRIGATION DISTRICT <br /> PJ BQX-299 3514 W LEHMAN RD <br /> TR 5378_0299 a7 TRACY, CA 95304 <br /> A tir OWNER BANTA-CARBONA ID <br /> Health <br /> Date Dem,-.ipt:,. AiTIUUrit � <br /> L- P.09ram <br /> Invoice ft IN0157751 ---Date of Invoice: 112512007 I I[IIIII IIIIII III VIII VIII VIII IMI IIII1 VIII VIII VIII VIII IIII IIIIIi IIfII IIII IIII <br /> 1125/2007 2244 2007 HAZMAT FEE $ 435.00 <br /> 1/25/2007 2390 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 459.00 <br /> Please change mailing address to: <br /> Banta-Carbona Irrigation District 4W;; <br /> 3514 W. Lehman Rd. <br /> Tracy, CA 953041 <br /> 4- <br /> h'�.. <br /> s 6 t�, <br /> d0AQ, <br /> J�Ttvk�A Ty��g�� LPL`+Y <br /> a�NT <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 1 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 /> ,2 4 rpt - <br />