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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTIV --T <br />600 E MAIN STREET <br />STOCKTON, CA 95202 <br />Phone: (209) 468-3420 <br />INVOICE <br /> <br /> <br /> <br />Page 1 <br />COPY <br />Account ID <br />AR0016621 <br />Facility ID <br />FA0009621 <br />Date Printed <br />1 1/28/2008 <br />RE: JACK RABBIT <br />471 INDUSTRIAL AVE <br />RIPON, CA 95366 <br />OWNER: EARL M ANDERSON <br />Date Health <br />Program Description Amount <br />Invoice # IN0170275 --- Date of Invoice : 1/25/2008 <br />1/25/2008 2220 SM HW GEN <5 TONSNR <br />1/25/2008 2244 2008 HAZMAT FEE <br />1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />IIIIIII IIIIII 111 11111 IIIA 1111 11111 IIIA 11111 11111 IIIA <br />VIII IIII <br />$ <br />111111 VIII IIII IIII <br />213.00 <br />$ <br />375.00 <br />$ <br />24.00 <br />Total for this Invoice <br />$ <br />612.00 <br />Payment Due Date <br />2/27/2008 <br />$ <br />! 612.00 <br />TOTAL DUE this Billing Period <br />i <br />PAYMENT <br />RECEIVED <br />FEB 2 2 2oo3 <br />SAN JOAQUIN <br />COUNTY <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT. <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 />1-54. rpt <br />