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n uD/LU10/1tlU UO: 55 AM ll(;S FAX No, 19163765372 P. 001/001 <br /> SAN JOAQUIN COUNTY <br /> NVfRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 'Rill 868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phbne: (209) 468-3420 r Dv <br /> ��'` ' VO'C V O1 1 Account ID AR0016961 <br /> M�c,y�LL�' / FecilifylD FA0009981 <br /> Date Printed 3/31/2015 <br /> ,eOAI <br /> RE : CALIFORNIA STATE BLDG <br /> CALIFORNIA STATE BLDG 31 E CHANNEL ST 108 <br /> 31 E CHANNEL ST#108 STOCKTON, CA 95202 <br /> STOCKTON, CA 95202 <br /> OWNER : CALIFORNIA STATE BLDG <br /> Date Health <br /> Program Descdptfon <br /> Amount <br /> Invoice# IN0261168---Date oflnvoice, 1/29/2015 �111111111111111111111fill 11111111U11111IN111111111111111INII➢II11111 fill IfII <br /> 1292015 1920 HMBP-Common Materials $ 100.00 <br /> 1/292015 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/292015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> 3/152015 9957 Hae Mat Program Penalty Fee S 10.00 <br /> Toblforthls invoice $ 358.00 <br /> r <br /> at 4✓ ^� DU <br /> Payment Due Date 2/28/2015 <br /> WO.WOtp,.p APl r1r;TATE YOUR <br /> RAW .NT'rODAYI TOTAL DUE this Billing Perjoclk $ 358.00 <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 HMBP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at tha Rate of 101/6 Penalties will be added at the Rate of 10% <br /> 70 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> Received Tlme—Apr, 9. 4015--10: 00AM—No. 8484 <br /> 5254.rpt <br />