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SAN JOAOUIN COUNTY PUBLIC 'ALTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> 209-468-3420 <br /> INVOICE Account ID AR0018042 <br /> FA0011042 <br /> Facility ID <br /> Date Printed 2/1/01 <br /> <br /> <br /> <br /> <br /> OWNER : ASH QADDOURA <br /> Health <br /> fDate Program Description Hrs Employee Amount <br /> Invoice# IN0081169 Date of Invoice. 1/30/01 <br /> 1/30/2001 2220 SM HW GEN<5 TONSNR <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $100.00 <br /> $10.00 <br /> Total for this Invoicel $110.00 <br /> Payment Due Date 3/3/2001 <br /> TOTAL DUE this Billing Periodl $110.00 <br /> Please make Checks PAYABLE to: PHS/EHD / Return a 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 andeach 30 thereafter <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 12001 <br /> SAN JOAOU.N C,OUNTY <br /> PLSLIC N�-Ai1`I SSRI+ICES <br /> ENVII 'TkL H6 P l IVISON <br /> 5255.rpt <br />