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. ""IfICNIAL HEALTH DEPARTM"tT <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Page <br /> Phone: 1 <br /> (209)468-3420 <br /> INVOICE COPY <br /> Account ID AR0016464 <br /> Facility ID FA0009464 <br /> Date Printed 1/26/2007 <br /> TOWER PARK RESORT/MARINA UMMMONNUMONJ <br /> <br /> 14900 W HWY 12 <br /> LODI, CA 95242 <br /> OWNER : TOWER PARK MARINA INVESTORS LP <br /> Date Health <br /> ---- —Aro�ram Description <br /> Amounl <br /> nvoice# IN0156574---Date of Invoice: 1/25/2007 IIIIIIIIIIIIII III VIII VIII VIII VIIIIIIIIIIIII VIII VIII VIIIIIIIIIIIII VIII IIIIIIII <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 206.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 330.00 <br /> $ 24.00 <br /> Tot, this Invoice $ 560.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 560.00 <br /> REQ ED <br /> FEB 0 7 2007 <br /> SAN kOAQUIN GOUtM <br /> HEE"'LTH DEPARTMENT <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 /> X254 rpt <br />