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J, Page 1 <br /> SAN ►AQUIN COUN I Y <br /> ENV )NMENTAL HEALTH DEPARTMENT <br /> 304 VEBER AVE-3RD FLOOR <br /> 5TC ;70N, CA 95202 <br /> Rho (209)468-3420 AR0025211 <br /> pccountlD <br /> INVOICE <br /> Faality iD FA0014798 <br /> Date Printed 4!2612004 <br /> /►r(tn.Jeff (soak RE ; MOUNTAIN HOUSE NEIGHBORHOOD I- <br /> SH ELL OIL *"'f-Fee>duLe-�S (kS tJ MASCOT &MARINA BLVD <br /> P&B93E�4Sa A S 25 l3 a�'�"�'`� S T RACY, CA 95376 <br /> X-7-469Sea (e W a g8l 3'{ <br /> OWNER: TRIMARK COMMUNITIES <br /> Amount <br /> Health <br /> Date Program Description <br /> Im e# INo109851---Rate of Invoice: T11712003 Hrs Employee $ 151.30 <br /> 16/2003 2950 315-REPORT REVIEW <br /> 1.70 INFURNA ($ 287.00) <br /> PAYMENT $ 80.10 <br /> 17/2003 9999 p.90 INFURNA $ 26.70 <br /> 17/2003 2950 315-REPORT REVIEW 0.30 INFURNA <br /> 312-GONSULTATION $ 195.30 <br /> 9/2003 2960 2.10 INFURNA <br /> 1 4/2003 2950 315-REPORT REVIEW <br /> 186.40 <br /> Totei for this Invoice $ <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 786.40 <br /> FAST " 'I*--a <br /> WE WOULD APPRECIATE YOUR <br /> PAYMENT TODAY! <br /> SID <br /> 70 <br /> �Nl HEP\AN <br /> Please make Checks PAYABLE to: 'EHD' Retum a Copy of This STATEMENT with Your PAYMENT <br /> For all SERVICE FEES <br /> Penalties will be added to all Permit Fees <br /> For OES 1 HMMP Fees penalties will be <br /> added at the Rate of 10% <br /> will be 60 pays after the invoice Data and each 30 Pays thereafter <br /> at the Rate of 100%of the Base Fee Penalties <br /> Days aft:'t I Vo Date f 10% <br /> 30 Days after the Due Date <br /> 0[A , KDN SKIVID AN3 9Z69 Tv6 CTL XVJ 60:9T 311.E fi0/TT/90 <br />