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SAN JOAOUIN COUNTY PUBLIC L ..LTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 9 <br /> <br /> <br /> Facility ID FA0009992 <br /> Date Printed 1/31/01 <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# IN0080302--Date of Invoice: 1/30/01 <br /> 1/30/2001 2220 SM HVV GEN<5 TONS/YR $100.00 <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $110.00 <br /> Payment Due Date <br /> TOTAL DUE this Billing Periodl $110.0 <br /> 7- <br /> Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMEN <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 /> PAYMENT <br /> RECEIVED <br /> FEB 12 2001 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 5255.rpt <br />