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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0023512 <br /> Facility ID FA0013927 <br /> Date Printed 5/1/2003 <br /> HOLLIS PHILLIPS RE : DOW <br /> URS 400 W GANDY DANCER <br /> 221 MAIN ST 600 TRACY, CA 95377 <br /> SAN FRANCISCO, CA 94105 <br /> OWNER : BACKLUND, DALE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0101384---Date of Invoice: 11/19/2002 <br /> Hrs Employee <br /> 10/25/2002 2960 315-REPORT REVIEW 0.50 INFURNA $ 44.50 <br /> 11/12/2002 2960 315-REPORT REVIEW 1.30 INFURNA $ 115.70 <br /> 11/14/2002 2960 310-FIELD CONSULT 1.20 INFURNA $ 106.80 <br /> 12/5/2002 9999 PAYMENT (S 142.40) <br /> 1/13/2003 9999 PAYMENT (S 44.50) <br /> Total for this Invoice $ 80.10 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 80.10 <br /> N0 <br /> -G9NRK-ffx <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 <br />