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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMr <br /> 304 E WEBER AVE -3RD FLOOR ^" <br /> STOCKTON, CA 85202 COPY <br /> Phone: (269)468-3420 <br /> INVOICE Account ID AR0017511 <br /> FacilityID FA0010511 <br /> Date Panted 1/30/2006 <br /> UNIV OF THE PACIFIC -PHARMACY RE : UNIV OF THE PACIFIC - PHARMACY <br /> 3601 PACIFIC AVE 751 W BROOKSIDE RD <br /> STOCKTON, CA 95211 STOCKTON, CA 95211 <br /> OWNER : UNIV OF THE PACIFIC - PHARMACY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0143055---Date of Invoice: 1/2712006 11p1111Fill III 1pp1p11pp111111p111p1pFill IIIII ilill 1p1p1111p111lillIN <br /> 1/27/2006 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 315.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoicel $ 539.00 <br /> Payment Due Date 311/2006 <br /> TOTAL DUE this Billing Period $ 539.00 <br /> FES 2 4 2006 <br /> SAN'10, <br /> HEENV OUM yC j), <br /> ALTH�P4R MFt <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 I 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 /> 5254.rpt <br />