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.)AN JOAQUIN COUNTY <br /> ENVIRQM11�iENTAL HEALTH DEPARTM� 1101Page 1 <br /> 304 It WEBERAVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID I AR0017090 <br /> Facility ID FA0010090 <br /> Date Printed 2/27/2004 <br /> PATRICK HOLLINGSWORTH RE : AAA MACHINE <br /> AAA MACHINE 121 E LINDSAY ST <br /> PO BOX 997 STOCKTON, CA 95202 <br /> STOCKTON, CA 95201 <br /> OWNER : PATRICK HOLLINGSWORTH <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0115892---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 224.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 224.00 <br /> SMON <br /> R c� <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH 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 /> 5255.rpt <br />