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amil JUMWUIIV I.UUIV I r Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMS" ' <br /> 304 E WEBER AVE -3RD FLOOR0 <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID 127 <br /> FA0010146 <br /> Facility ID <br /> t <br /> Date Printed 1/26/2007 <br /> C&S ONE HOUR MARTINIZING RE : C&S ONE HOUR MARTINIZING <br /> 5756 PACIFIC AVE STE#1 5756 PACIFIC AVE STE 1 <br /> STOCKTON, CA 95207 STOCKTON, CA 95207 <br /> OWNER : PATEL, CHANDRAKANT B "CHARLES" <br /> Date Health <br /> i rl <br /> ProgFam. accri74inn Amount <br /> Invoice# IN0156795---Date of Invoice: 1/25/2007 I I111I1I1III11III VIII VIII111I11I11I VIII VIII VIII IIIII 111111 11111 III IIII <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 255.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 485.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 485.00 <br /> PAYMENT <br /> IFEB 0 1 jr. <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH 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 /> 5254.rpt <br />