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SAN OOAQUIN COUNTY Page 1 <br /> ,,EWARONMENTAL HEALTH DEPARTPIFT • <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID RR0005748 <br /> Facility ID FA0005287 <br /> Date Printed F-1—/2-4120-05 <br /> LOMMMEMENEVENOMA <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# IN0128508--Date ofInvoice: 1/24/2005 p111111p1111111111IN1111111p11p11IN <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/2412005 2244 2005 HAZMAT FEE $ 315.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this lnv2!Lej $ 539.00 <br /> Payment Due Date 2/2312005 <br /> TOTAL DUE this Billing Period $ 539.00 <br /> el <br /> ECEVE� <br /> " 4 2005 <br /> MA OAQUINeN PEttf <br /> SPNO`jHOOFFN M <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 />