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SAN!OAOUIN COUNTY PUBLIC*.OALTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 �\ <br /> 209468-3420 <br /> INVOICEAccount lD 1 ^LMMMMIMMMMMINININA■ <br /> FA0000381 <br /> Facility ID <br /> LMMMMMMMINNUA <br /> Date Printed 1/31/01 <br /> KAREN FERRANTE Y /RE : TE AID#6000 <br /> RITE AID#0" 520 W LODI AVE <br /> <br /> OWNER: PAYLESS DRUGSTORES INC <br /> Health_.. <br /> Date Program Description Hrs Employee Amount <br /> Invoice 0 IN0079267--Date of Invoice: 1/30101 <br /> 1/30/2001 2220 SM HW GEN<5 TONSNR $100.00 <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $110.00 <br /> Payment Due Date 121200 <br /> TOTAL DUE this Billing Periodl $110.00 <br /> Please make Checks PAYABLE to: PHS/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 thereafter <br /> PAYMENT <br /> RECEIVED <br /> MAR 0 12001 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 5255.rpf <br />