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SAN JOAQUIN COUNTY PUBLIC--EALTH SERVICES <br />ENVIRONMENTAL HEALTH DI ION <br />304 E WEBER AVE - 3RD FLOOR <br />STOCKTON, CA 95202 <br />209-468-3420 <br />INVOICE <br /> <br /> <br /> <br /> <br />Page 1 <br />Account ID AR0016621 <br />rullwuo <br />FA0009621 <br />Facility ID <br />Date Printed 3/14/01 <br />RE: JACK RABBIT <br />471 INDUSTRIAL AVE <br />RIPON CA 95366 20 <br />OWNER: EARL M ANDERSON <br />Health <br />Date Program Description Hrs Employee Amount <br />rvoice # IN0080002 --- Date of Invoice : 1/30101 <br />1/30/2001 2220 SM HVV GEN <5 TONSNR $100.00 <br />1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br />Total for this Invoice $110.00 <br />Payment Due Date 01 <br />TOTAL DUE this Billing Period $110.0 <br />Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYM T <br />Penalties will be added to all Permit Fees For all SERVICE FEES <br />at the Rate of 100% of the Base Fee Penalties will be added at the Rate of 10% <br />30 Days after the Due Date 60 Days afterthe Invoice Date and each 30 thereafter <br />PAYMENT <br />RECEIVED <br />MAfj 14 2091 <br />SAN JOAQUIN COUNTY <br />PUBLIC HEALTH SERVICES <br />ENVIRONNVENTAL HEALTH DIVISION <br />5255. rpt <br />