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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTI Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD I AR0027290� <br /> Facility ID FA0015758 <br /> Date Printed 2/15/2005 <br /> VAN DE POL ENT INC-PRIMARY RE : VAN DE POL ENT INC-PRIMARY <br /> <br /> STOCKTON, CA 95206 <br /> OWNER : VAN DE POL ENTERPRISES INC. <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0130269---Date of Invoice: 1/24/2005 111111111 IN <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 375.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 599.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 599.00 <br /> �P:YIV1Ei�l� <br /> 9ECEIVEE <br /> FEB 1 4 2005 <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 OES/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 /> J25J.rpt <br />