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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMW w <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0017146 <br /> Facility IDFA0010146 <br /> Date Printed 2/5/2004 <br /> C&S ONE HOUR MARTINIZING RE : C&S ONE HOUR MARTINIZING <br /> 5756 PACIFIC AVE#1 5756 PACIFIC AVE 1 <br /> STOCKTON, CA 95207 STOCKTON, CA 95207 <br /> OWNER : PATEL, CHARLES <br /> Date Health —_— - <br /> Program Description Amount <br /> Invoice# IN0115920---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 255.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 479.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 79.00 <br /> PAYMENT <br /> RECEIVEC.+. <br /> r EB 1. 2 2004 <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 i'sase Fee ?eiia!ties .vill 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.ipt <br />