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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTT Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Amount AR0001456 <br /> Facility ID F FA0001457 <br /> Date Printed 2/27/2003 <br /> COLLEGEVILLE MARKET &CAFE RE : COLLEGEVILLE MARKET & CAFE <br /> 13521 E MARIPOSA RD 13521 E MARIPOSA RD <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 <br /> OWNER : LUKOSE,JOSEPH <br /> Date Health <br /> Program Descriptio Amount <br /> Invoice# IN0102885—Date of Invoice: 2/19/2003 <br /> Hm Employee <br /> 1/21/2003 4634 552-LEGAL ACTION/INVESTIGATION 0.50 NG $ 4 . <br /> Total for this Invoice $ 44.50 <br /> Payment Due Date 003 <br /> Invoice# IN0104805---Date of Invoice: 2/27/2003 <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 115.00 <br /> 2/27/2003 2301 UST STATE SURCHARGE $ 10.00 <br /> 2/27/2003 2301 UST STATE SURCHARGE $ 10.00 <br /> 2/27/2003 2360 ADDITIONAL UST $ 125.0 <br /> 2/27/2003 2362 UST FACILITY& 1 TANK $ 500.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ <br /> Total for this Invoice $ 777.50 <br /> Payment Due Date 3/29/ 3 <br /> TOTAL DUE this Billing Period $ 822.00 <br /> PAYMEIVT <br /> RECEIVED <br /> MAR 13 2003 <br /> SAN JOAOUIN COUNTY <br /> P060C HEALTH SER NCES <br /> ENVIRONMFNTAT HEAITH OIVIg,,,y,/ <br /> Please make Checks PAYABLE to: 'EHO' – 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 and each 30 Days,thereafter <br /> 5255.rpt <br />