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SAN JOAQUIN COUNTY <br /> ENVIRONMENThL HEALTH DEPARTN�T • Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 4 <br /> INVOICE AccountlD AR0017273 <br /> Facility ID F FA0010273 <br /> Date Printed 2/27/2003 <br /> COSTCO WHOLESALE -MEATS#210 RE : COSTCO WHOLESALE -MEATS#210 <br /> <br /> TRACY, CA 95376 <br /> OWNER : COSTCO WHOLESALE CORP <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0103773---Date of Invoice: 2/2712003 <br /> 2/27/2003 2214 CaIARP FAC STATE SURCHARGE FEE $ 200.00 <br /> 2/27/2003 2220 SM HW GEN<5 TONSNR $ 200.00 j <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 570.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total forthis Invoicel $ 987.50 <br /> Payment Due Date 3/29/2003 <br /> TOTAL DUE this Billing Period $ 987.5 <br /> PAYMENT <br /> RECEIVED <br /> MAR 1 7 2003 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAI HEALTH ONISION <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 all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5255.rpt <br />