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'SAN JOAOUIN�COUNTY PUBLIC HEALTH SERVICES Page 1 <br /> 304 E WEBER <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> OWNER: ROSENTHAL TRUST <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0082430—Date of Invoice: 322101 <br /> 3/22/2001 2301 UST STATE SURCHARGE $8.00 <br /> 3/22/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $18.00 <br /> Payment Due Date 4/ /2001 <br /> TOTAL DUE this Billing Period $18.00 <br /> Please make Checks PAYABLE to: PBS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penaltieswill 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 /> RECE VED <br /> 2 "rit� <br /> SAN JOAgUP06FN41N COFNVIRONMj HFATH <br /> ESN <br /> 5255.rpt Nftw� '`( <br />