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SAN JOAQUIN COUNTY <br /> ENVIRONMENTP„L HEALTH DEPARTV -`IT Page 1 <br /> 304 E WE6ER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0018159 <br /> Facility ID FA0011159 <br /> Date Printed 6/29/2004 <br /> SRUSURGICAL EXPRESS RE : SRI/SURGICAL EXPRESS <br /> <br /> STOCKTON, CA 95206 <br /> OWNER : SRI/SURGICAL EXPRESS <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0122169---Date of Invoice: 6/29/2004 I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII 11111 <br /> IIII IIII <br /> 6/29/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> Total for this Invoice $ 200.00 <br /> Payment Due Date 7/29/2004 <br /> TOTAL DUE this Billing Period $ 200.00 <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 />