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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM� 'T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR , <br /> <br /> <br /> <br /> <br /> <br /> <br /> 13300 WHITE ROCK 18600 CORRAL HOLLOW RD <br /> RANCHO CORDON , CA 95742 TRACY, CA 95377 <br /> OWNER : STATE OF CALIFORNIA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0142680---Date of Invoice : /27/2006 11111111111 E 11111 11111 11111 11111 11111 11111 11111 lit 1111�1111 11111�11111 IE�111 <br /> 1/27/2006 2220 SM HW GE N <5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZ AT FEE $ 360.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE S 24 00 <br /> Total for this Invoice $ 584.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 584.00 <br /> PAW.I-:: ,,1 f <br /> MAR (i 3 206) <br /> SAN JOAQUIN COUNT`:' <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 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 /> i?i4 rpt <br />