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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM , r ..r <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0017935 <br /> Facility ID F FA0010935 <br /> Date Printed 4/23/2003 <br /> <br /> <br /> STOCKTON, CA 95205 <br /> OWNER : JOSE LUIS LOPEZ <br /> Health <br /> """ Program Desc::pticc Amount <br /> Invoice# IN0103924—Date of Invoice: 2/27/2003 <br /> 2/27/2003 2220 SM HVV GEN<5 TONS/YR $ 200.00 <br /> 2/27/2003 2244 PACT TRANSFER RECORD-OES $ 100.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> 4/15/2003 9987 Haz Mat Program Penalty Fee $ 10.00 <br /> To for this Invoice $ 327.50 <br /> Payment Due Date 3/29/2003 <br /> TOTAL DUE this Billing Period $ 327.50 <br /> OUH HEALTH P2HMIT F(`F. <br /> THE(*. JRHFPITYEAR <br /> ,VILL NJT a_ !SSUED UNTIL PAYMENT <br /> PASTDUEA".COUNTS RECEIVED <br /> ARE PAID IN FULL_ <br /> MAY - 8 2003 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <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 I 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 /> _55 mt <br />