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ClIVIKUNIVIENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE - Page 1 <br /> STOCKTON,^CA 95205 -- <br /> Phone: (209)468-3420 pool <br /> INVOICE Account to AR0017223 <br /> Facility to FA0010223 <br /> IMMMOMMOMMMMI <br /> l U Date Printed 2/13/2015 <br /> RMB GARAGE <br /> PO BOX 168 RE : RMB GARAGE <br /> MOUNTAIN RANCH, CA 95246-0168 715 N HUNTER ST A <br /> STOCKTON, CA 95202-1720 <br /> OWNER : JANOFSKY, JON <br /> Date Health <br /> Program Description <br /> Amount <br /> invoice 0 IN0261281 —Date of Invoice: 1/29/2015 <br /> 1/29/2015 1920 HMBP-Common Materials IIIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIIIIIIIIIIInIIIIIIIINIAIIyI16IIIIIHIIIUI9u <br /> 1@9/2015 2220 SM HW GEN<5 TONS/YR $ 205.00 <br /> 1/29/2015 2399 UNIFIED PROGRAM FAC STATE SU CHARGE FEE $ 213'00 <br /> $ 35.00 <br /> Total for NIS Invoice $ 453.00 <br /> Payment Due Date ?/26/2015 <br /> ° TOTAL DUE this Billing Period0 -�^ <br /> 51p\5 <br /> MpR <br /> Co /� /�' ©l`f �• N O G✓�/LL� f- G/LL�' /r70✓��� � C'i�Q.G% .S/'!iV J�hrQ�9/'v <br /> ACL v <br /> C) <br /> Massa <br /> Ci✓c c,ehs c��,�. r <br /> u,��c�c fir= s;i✓�'�z�/J o��z�i�aol �S a �- ✓v�y / dais. <br /> Please make Checks PAYABLE to: 'EHD' - Return a Copy of This STATEMENT wit our YMENT <br /> Penalties will be added to all Permit Fees For HMBP Fees <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% CE FEES <br /> Penalties will be added For all I at the Rate of 10Y. <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 /> 254.rp1 <br />