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ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 304 F WMER AVE -3RD FLOOR • <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0027142 <br /> LMMMMMMMMMMII <br /> Facility ID F—FA 0015684 <br /> Dale Printed 9/27/2004 <br /> LEACH, CLIFF RE : WRENCHERS/CLIFF LEACH #31 <br /> WRENCHERS/CLIFF LEACH #31 619 E FREMONT ST STE 31 <br /> 16 N AMERICAN ST APT#108 STOCKTON, CA 95202 <br /> STOCKTON, CA 95202 <br /> OWNER : LEACH, CLIFF <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0124455--Date of Invoice: 912412004 11111111111111110 111111111111111 IN <br /> 9/24/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 9/27/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 224.00 <br /> Payment Due Date 1012412004 <br /> TOTAL DUE this Billing Period $ 224.00 <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 />