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SAN JOAOUIN COUNTY PUBLIC 'ALTH SERVICES %..do Page 1 <br /> ENVIRONMENTAL HEALTH DIV"ledON <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> 209468-3420 <br /> INVOICE AccountlD AR0016021 <br /> LUMMOOMMMUMMM <br /> Facility ID FA0009021 <br /> mmmmmwmmmmmm <br /> Date Printed 1/31/01 <br /> LARRY HASKIN PLANT MGR RE : MENDOCINO ICE CREAM CO <br /> MENDOCINO ICE CREAM CO 110 S CHEROKEE LN <br /> 110 S CHEROKEE LN LODI CA 95240 20 <br /> LODI CA 95240 <br /> OWNER: FOREST WILLIAMS <br /> Health <br /> Date Program Description Firs Employee - - Amount <br /> Invoice# IN0079588--Date of Invoice: 1/30/01 <br /> 1/30/2001 2220 SM HW GEN<5 TONSNR $100.00 <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $110.00 <br /> Payment Due Date 3/2/2001 <br /> TOTAL DUE this Billing Period $110.00 <br /> Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10 <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> 5255.rpt <br />