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SAN JOAQUIN COUNTY <br /> ENVIRC-NMENTAL HEALTH DEPARTMFNT Page 1 <br /> 3G4 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0016961 <br /> Facility ID FA0009961 <br /> Date Printed F 2/24/2005 <br /> CALIFORNIA STATE BLDG RE : CALIFORNIA STATE BLDG <br /> 31 E CHANNEL ST#108 31 E CHANNEL ST 108 <br /> STOCKTON, CA 95202 STOCKTON, CA 95202 <br /> OWNER : CALIFORNIA STATE BLDG <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0128154---Date of Invoice: 1/24/2005 IIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIII IN 1111 <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR <br /> $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE <br /> $ 270.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 494.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 494.00 ; <br /> 2E <br /> FEB 2 4 20ah <br /> SA14 jOAOUIN COUNTY <br /> ENVIRONMENTAL <br /> HE.p,LTH 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 /> 5255.rpt <br />