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SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTO <br /> <br /> 6992 <br /> Facility ID FA0009992 <br /> Date Printed 2/6/2002 <br /> NANCY BENNETT RE: GB INDUSTRIAL SPRAY INC <br /> GB INDUSTRIAL SPRAY INC 1140 BESSEMER AVE#1 <br /> 1140 BESSEMER AVE#1 MANTECA CA 95337 20 <br /> MANTECA CA 95337 OWNER: GARY BEAUCHAMP <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0091550—Date of Invoice: 1/22/2002 <br /> 1/22/2002 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $17.50 <br /> 1/22/2002 2220 SM HW GEN L5 TONS/YF $200.00 <br /> Total for this Invoice $217.50 <br /> Payment Due Date 20 <br /> TOTAL DUE this Billing Period '$217.5,0 <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 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 /> PAY iViEN <br /> RECE1VEG <br /> LIAR 112092 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> FNVIRONMRITAI HEALTH DNI810N <br /> 5255.rpt <br />