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Omly JUAWUIN cUUNTY <br /> ENVIRCNMENTAL HEALTH DEPARTM T <br /> 600 E MAIN STREET Page 1 <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account[D AR0022667 <br /> Facility ID F FA0013558 <br /> Lmummmmonommoi <br /> Date Printed F 2/28/2008 <br /> <br /> <br /> LODI, CA 95240 <br /> OWNER : KEMPER REFRIGERATION <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# ING170723--Date of invoice: 1/25/2008 1111111111111111 1111111111111111111111111111111111111111111111111111111IIII111111111111 IIII IIII <br /> 1/25/2008 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE S 300.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE S 24.00 <br /> Total forthislnvcice $ 537.00 <br /> Payment Due Date 2127/2008 <br /> TOTAL DUE this Billing Period E 537.00 <br /> PAYMENT <br /> RECEIVED <br /> - MAR 2 7 2008 <br /> SAENVOAQUIN COUNTY <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 /> -'_s;gn <br />