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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMIO • <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0040251 <br /> Facility ID F FA0022069 <br /> Date Printed 1/29/2014 <br /> LUMMENEENEEl <br /> ALESSANDRO, ANNE RE : WILSON WAY TIRE CO INC <br /> WILSON WAY TIRE CO INC 1535 E MAIN ST <br /> 1537 E MARKET STOCKTON, CA 95205 <br /> STOCKTON, CA 95205 <br /> OWNER : WILSON WAY TIRE CO INC <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0246055---Date of Invoice: 12/11/2013 IIII IIII VIIIIIIVIVI VIIIVIVIIIVIIVIIIIIIIIIVIII IIII <br /> Him Employee <br /> 12/11/2013 9999 PAYMENT ($ 375.00) <br /> 1/22/2014 2953 315-REPORT REVIEW 3.50 HENDERSON $ 437.50 <br /> 1/23/2014 2953 312-CONSULTATION 2.50 HENDERSON $ 312.50 <br /> 1/23/2014 2953 315-REPORT REVIEW 2.50 HENDERSON $ 312.50 <br /> 1/24/2014 2953 312-CONSULTATION 2.50 HENDERSON $ 312.50 <br /> 1/24/2014 2953 315-REPORT REVIEW 2.50 HENDERSON $ 312,50 <br /> Total forthis Invoice $ 1,312.50 <br /> Payment Due Date 2/2812014 <br /> TOTAL DUE this Billing Period $ 1,312.50 <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 HMBP 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 /> 5254.rpt <br />