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ENVIRONMENTAL HEALTH DEPARTMF <br /> iv VI F <br /> 3F04 EVEBER AVE -3RD FLOOR '' Page 1 <br /> STOCKTON, CA 95202 �► <br /> Phone: (209)„468-3420 <br /> INVOICE <br /> Account IDAR0025513 <br /> Facility ID FA0014942 <br /> Date Printed 3/26/2004 <br /> BEN MARRACCINI RE :1TRIPLEX RENTAL <br /> TRIPLEX RENTAL 4602 CHEROKEE RD t <br /> 4636 CHEROKEE RD JSTOCKTON, CA 95215 <br /> STOCKTON, CA 95215 <br /> OWNER :Il MARRACCINI,BEN E <br /> Health I <br /> Date I Program Description <br /> Amount <br /> Invoice# IN0118670—Date of Invoice: 3/26/2004 I <br /> Hrs Employee <br /> 3/22/2004 3030 315-REPORT REVIEW 0.50 !.INFURNA $ 46.50 <br /> 3/24/2004 i 3030 315-REPORT REVIEW 1.30 li INFURNA $ 120.90 <br /> Total for this Invoice $ 167.40 <br /> i <br /> Payment Due Date 4/25/2004 <br /> li <br /> TOTAL DUE this Billing Periodi $ 167.40 <br /> E <br /> i <br /> „ s <br /> l <br /> i <br /> J <br /> i <br /> i <br /> h <br /> i <br /> i <br /> i <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 /> 5255.rpt a <br />