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UPJvVW^WU111 VUUIY1 T <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 600r- MAIN STREET <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID A 00016443 <br /> LIMEMMUMOMMMMill <br /> Facility ID FA0009443 <br /> Date Printed 1/29/2009 <br /> AMTEXINC RE : AMTEXINC <br /> 550 CARNEGIE ST 550 CARNEGIE ST <br /> MANTECA, CA 95337 MANTECA, CA 95337 <br /> OWNER : LEARIHAYASHI TELEMPU <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0184107—Date of Invoice: 1/2912009 �11111111111111111111111INIIIII111111111111111111111111111 <br /> 1/29/2009 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 345.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 582.00 <br /> Payment Due Date 2128/2009 <br /> TOTAL DUE this Billing Period $ 582.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 11 2009 <br /> SAN JOAOUIN 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 /> 254.rpt <br />