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rayc <br /> ENVIRONMENTAL HEALTH DEPARTMEO ..� • <br /> 304 E WEEIER AVE-3RD FLOOR <br /> STOWON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0005748 <br /> Loommmmommma <br /> Facility ID FA0 00 2287 <br /> LOOMONOMMMMONE <br /> Date Printed 1/30/2006 <br /> HERMAN & HELENS MARINA RE : HERMAN & HELENS MARINA <br /> 15135 W EIGHT MILE VENICE ISLAND FERRY 15135 W EIGHT MILE RD <br /> STOCKTON, CA 95219 STOCKTON, CA 95219 <br /> OWNER : SMITH,ANDREW <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0143227--Date of Invoice: 1/27/2006 iiiiiiiiiiiii ElllliliiilliiliiNiliiliiiiiiliililliiiiiillliililiiliiiiliiiiiili1 <br /> 1/27/2006 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 315.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 539.00 <br /> Payment Due Date 3/112006 <br /> TOTAL DUE this Billing Period $ 39.00 <br /> SAN oAR (16 2006 <br /> FNvi o�in/ <br /> '5-40-" <br /> T H'EpAH 4 <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 DES 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 />