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JAN JVAUUIN L UUN 1 T <br /> ENVIRONMENTAL HEALTH DEPARTM& Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKPhone: ON,209 46 95202 COPY <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0020415 <br /> Facility ID F FA0012503 <br /> Date Printed 1/26/2007 <br /> LNEEMINEMENIMMMIll <br /> SAN JOAQUIN RIVER CLUB RE : SAN JOAQUIN RIVER CLUB <br /> 30000 KASSON RD 30000 KASSON RD <br /> TRACY, CA 95376 TRACY, CA 95376 <br /> OWNER : SAN JOAQUIN RIVER CLUB <br /> Date Health <br /> Program Description _ Amount <br /> Invoice# IN0157036--Date of Invoice: 1/25/2007 1111111111111111111111111111 <br /> 1/25/2007 2220 SM HW GEN <5 TONSIYR $ 206.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 230.00 <br /> Payment Due Date 2I SI2007 <br /> TOTAL DUE this Billing Period $ 230.0 <br /> PAYMENT <br /> RECEIVED <br /> FEB 14 mO <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPgRT&,fENT <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 />