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JAN JUAUUIN GUUN I Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMV • <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOPhone: ON,(209 46 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0016618 <br /> Facility ID FA0009618 <br /> Date Printed 1/30/2006 <br /> STEVE GARCIA RE : FOOD EXPRESS INC <br /> WALTER KEENEY 1250 E MADRUGA RD <br /> <br /> <br /> OWNER : WALTER KEENEY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0142775---Date of Invoice: 1/27/2006 111111111111111111111111 IN <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 360.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 584.00 <br /> Payment Due Date 6 <br /> TOTAL DUE this Billing Period $ 584.00 <br /> REC�V G� <br /> COUNIN <br /> S�NV RONME" <br /> HEpLTHDEPARTME� FEB 1 5 2006 <br /> ENVIRONMENT HEALTH <br /> PERMIT/SERVICES <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 I 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 /> 5254.rpt <br />