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SAN JOAQUIN COUNTY Page 1 <br /> ENL'1RONM9NTAL HEALTH DEPARTM� • <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0017535 <br /> Facility ID FA0010535 <br /> Date Printed 1/30/2006 <br /> LIBERTY PRINTING INC RE : LIBERTY PRINTING INC <br /> 2601 TEEPEE DR 2601 TEEPEE DR <br /> STOCKTON, CA 95205-2421 STOCKTON, CA 95205 <br /> OWNER : MOSSBARGER,JAMES M <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0143061 ---Date of Invoice: 1/2712006 ����III111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIHE111111111111111111111111111111ININ <br /> $ 200.00 <br /> 1/27/2006 2220 SM HW GEN <5 TONS/YR $ 300.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 24.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br /> Total for this Invoice $ 524.00 <br /> Payment Due Date 3/1/2006 <br /> �1 <br /> TOTAL DUE this Billing Period $ 524.00 <br /> PAYMENT <br /> RECEIVED <br /> FES 2 3 2006 <br /> SAN JOAOUIPI COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> e a <br /> For all SERVICE FEES <br /> Penalties will be added to all Permit Fees For I Fees Penalties will be added at the Rate of 10% <br /> a a <br /> at the Rate of 100%of the Base Fee Penalties will be added <br /> 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 />