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SAN JOAQUIN COUNTY <br /> Page 1 <br /> ENVIRONMENTAL HEALTH DEP RTS IT <br /> 304 E WEBER AVE-3RD FLOOR <br /> STO <br /> , ;;I;(;;)G SIS:Ric! <br /> INVOICE �FIGfiRf �iUCt��� AR0016498 <br /> Account ID <br /> 05 JAN 27 PH ?: 25 <br /> Facility ID FA0009498 <br /> Date Printed 1/24/2005 <br /> SUSD STAGG HIC H SCHOOL RE : SUSD STAGG HIGH SCHOOL <br /> 55 S MADISON ST 1621 BROOKSIDE RD <br /> STOCKTON, CA 95203 STOCKTON, CA 95207 <br /> OWNER : STOCKTON UNIFIED SCHOOL DIST <br /> Date Health <br /> Program Description A-nount <br /> Invoice# IN0129162--Date of Invoice: 1/24/2005 11111 1111 111111 11111 1111 IN <br /> 1/24/2005 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 330.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 554.00 <br /> Payment Due Date 2/23/200 <br /> TOTAL DUE this Billing Period $ 554.00 <br /> APPROVED OR <br /> PAYME T _ os PAYMENT <br /> P RECEIVED <br /> FEB 1 5 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 Fec s 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 <br />