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SAN JOAQUIN COUNTY Page t <br /> ENVIRONMENTAL HEALTH DEPARTME� ../ <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0016042 <br /> Facility ID FA0011042 <br /> Date Printed 2/5/2004 <br /> <br /> <br /> MANTECA, CA 95337 <br /> OWNER : ASH QADDOURA <br /> Date Health <br /> Program Description _ _ Amount <br /> Invoice# IN0116144—Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 85.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 309.00 <br /> Payment Due Date 31612004 <br /> TOTAL DUE this Billing Period $ 309.00 <br /> PAYMENT <br /> RECEIVED <br /> MAR 3 - 2004 <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 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 /> 5255.rpt <br />