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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM* N Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR 0-204 55 <br /> LENOMMMMMMINIM <br /> Facility ID FA0012503 <br /> LMMMONNOMMMMA <br /> Date Printed 1/29/2009 <br /> INNOMMENEENIMMMOMM <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# IN0184557---Date of Invoice: 1/29/2009 IIIIIIIIIII VIVIIIVIIVIIIIIIIIIIVIIIVIIIVIIIIIIIIIIVII IIII IIII <br /> 1/29/2009 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice I $ 237.00 <br /> Payment Due Date 2/28/2009 <br /> TOTAL DUE this Billing Period $ 237.00 <br /> RECD FEB 09 2008 PAYMENT <br /> RECEIVED <br /> FEB 12 2009 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTHEALTH DEPARTMENT <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 /> 5254.rpt <br />