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JAI•I JVHI{VIIV IiVVIY I r i Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, 95202 COPY <br /> Phone:e: (209(209)46 46 8-3420 <br /> INVOICE Account 10 AR0017485 <br /> Facility ID FA0010485 <br /> Date Pnnted 1/30/2006 <br /> lawannommommmm <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 Amount <br /> Invoice# IN0143048—Date of Invoice: 1/27/2006 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIVIIIIIIIIIIIIIVIIIILIIVIIIIIIIIIIIIIIIIIIIIIIIIII <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 270.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 494.00 <br /> Payment Due Date _ 3/1/2006 <br /> i <br /> TOTAL DUE this Billing Period $ 494.00 <br /> F r 6 2 8 200, <br /> SAN JOAQUIN COUNW <br /> ENVIAGNMENTAL. <br /> HEALTH DEPARTi`4EN r <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 I 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 /> 5254.rpt <br />