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SAN JOAOUIN COUNTY ger' ../ Page l <br /> 1 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> Phone: 209468-3420 <br /> INVOICE Account ID AR001804z <br /> Facility ID FA0011042 <br /> Date Printed 2/6/2002 <br /> <br /> <br /> <br /> OWNER: ASH QADDOURA <br /> Health <br /> Date Program Description Hm EmployeeAmount <br /> Invoice# IN0092395---Date of invoice: 112212002 <br /> 1/22/2002 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $17.50 <br /> 1/22/2002 2220 SM HW GEN<5 TONSNF $200.00 <br /> Total for this Invoice $217.50 <br /> Payment Due Date <br /> TOTAL DUE this Billing Period 5217.50 <br /> Please make Checks PAYABLE to: EHD / Returns 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 thereafter <br /> 5255.rpt <br />