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AN .%OAQUIN COUNTY <br /> NVU�OWNENTAL HEALTH DEPARTM • Page 1 <br /> 304 � WEBER AVE -3RD FLOOR i <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID 0004177 <br /> Facility ID FA0004495 <br /> Date Printed 2/27/2003 <br /> RO-LAB AMERICAN RUBBER CO INC RE : RO LAB AMERICAN RUBBER CO <br /> P.O. BOX 450 8830 W LINNE RD <br /> TRACY, CA 95378-0450 TRACY, CA 95304 <br /> OWNER : RO LAB AMERICAN RUBBER CO INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0103254---Date of Invoice: 2/27/2003 <br /> 2/27/2003 2227 GEN 5<25 TONS PERMIT $ 1,568.00 <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 390.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Invoice $ 1,975.50 <br /> Payment Due Date 3/29/2003 <br /> TOTAL DUE this Billing Period $ 1,975.50 <br /> PAYMENT <br /> RECEIVED <br /> MAR 2 8 2003 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> FNVIRONMFNTAI HFAITH DIVISION <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 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 Days thereafter <br /> 5255.rpt <br />