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SAN JOAQUIN COUNTY PUBLIC HEA TH SERVICES <br /> EN'AAAENTAL HEALTH DIVISIPage 140 <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209-468-3420 <br /> INVOICE Account ID AR0016691 <br /> Facility ID FA0009691 <br /> Date Printed 6/2/00 <br /> ROBERT D GOSSARD RE: PG&E ROUGH&READY SUBSTATION <br /> PG&E 3515 NAVY DR <br /> 2730 GATEWAY OAKS DR STOCKTON CA 95203 20 <br /> SACRAMENTO CA 95833 <br /> OWNER: PG&E <br /> Health <br /> Date Program Description Him Employee Amount <br /> Invoice# IN0070312•—Date of Invoice: 4/19/00 <br /> 6/1/2000 9999 PAYMENT -$10.00 <br /> 4/19/2000 2220 SM HW GEN<5 TONSNR $100.00 <br /> 4/19/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $1D0.o0 <br /> Payment Due Date 7/212000 <br /> TOTAL DUE this Billing Period $100.00 <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 o((10 <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 3#thereafter <br /> 5255.rpt • • <br />