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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTVT <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID I AR0017535 <br /> Facility ID —FA 0-0 0-535 <br /> LEEMOMMEMMENNEN <br /> Date Printed 1/24/2005 <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 <br /> Program Description Amount <br /> Invoice# IN0128339---Date of Invoice: 1/24/2005 IIIIIIIIIIIVIIVIIVIIVIIVIIIVII VIIIVIVIIIIIII 11111111111 IIII IIII <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 300.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total forthis Invoicel $ 524.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 524:00 <br /> I <br /> PAYMENT <br /> RECEIVED <br /> FEB 1 0 2005 <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 DES/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 /> 5255.rpt <br />