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Om" OUAWUIN LIJUNIY <br /> ENVIRONMENTAL HEALTH DEPARTV NT Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR00t7485 <br /> Facility ID F FA0010485 <br /> IMMMMEMEMONEIN <br /> Date Printed 1/24/2005 <br /> REPORT RADIATOR RE : REPORT RADIATOR <br /> PO BOX 5475 2817 CHERRYLAND AVE 13 <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 <br /> OWNER : HAROLD ALLEN <br /> Date Health <br /> Program Description <br /> Invoice# IN0128326--Date of invoice: 1/24/2005 11111 IN 1111111111111111111111111 fill IIIII IN IIIIII 1111111 IN <br /> 1/24/2005 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 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 $ l 494.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 3 2005 <br /> SAN JOAOUIN COUNT/ <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 /> 5255.rpt <br />