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SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> Phone: 209-468-3420 <br /> INVOICE Account ID AR0016370 <br /> Facility ID FA0009370 <br /> Date Printed 2/5/2002 <br /> ROSE,DOUG RE: KUSTOM KURVES BODY SHOP <br /> KUSTOM KURVES BODY SHOP 4 N HOUSTON IN <br /> 4 N HOUSTON LN LODI CA 952402420 <br /> LODI CA 95240 OWNER: ROSE,DOUG <br /> Heal[h <br /> Date Program Description HM Employee Amount- <br /> Invoice# IN0091102--Date of Invoice: 1/22/2002 <br /> 1/22/2002 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $17.50 <br /> 1/22/2002 2220 SM HW GEN<5 TONS/YF $200.00 <br /> Total for this Invoice $217.50 <br /> Payment Due Date ;$21M;50 <br /> TOTAL DUE this Billing Period <br /> Please make Checks PAYABLE to: ERD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> PAYMENT <br /> RECEIVE-,;j <br /> FEB 13 2002 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ,'.�^��nA�f;IL NCS;iH DIV'SiGI� <br /> 5255.rpt <br />