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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM' 'T <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0022608 <br /> Facility ID F FA0013506 <br /> Lamommmmoommum <br /> Date Printed 2/5/2004 <br /> AUTOMOTIVE LABELS INC RE : AUTOMOTIVE LABELS INC <br /> PO BOX 1608 120 S AURORA <br /> STOCKTON, CA 95201 STOCKTON, CA 95202 <br /> OWNER : PATTERSON, KERRICK <br /> Date Health <br /> Frog= Description Amount <br /> Invoice# IN0116245--Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HIN GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 360.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoicel $ 584.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 584.00 <br /> BY:-------------------- <br /> PAYMENT <br /> RECEIVED <br /> FEB 1 7 ;n, :� <br /> SAN JOAQUIN COi Jpi i y <br /> ENMRONMf=NTA; <br /> HEALTH DEPAR,ilLNT <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 DES/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 />