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SAN JOAQUIN COUNTY i <br /> ENVIRONMENTAL HEALTH DEPARTP' "T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> <br /> <br /> INVOICE AccountlD AR0000355 <br /> Facility ID FAO 00356 <br /> Date Printed 1/24/2005 111 <br /> DAVID T PRICE INP RE : DAVID T PRICE INC <br /> 21657 E DODDS RID 21657 E DODDS RD <br /> ESCALON, CA 95320 ESCALON, CA 95320 <br /> OWNER : PRICE, DAVID T <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0128231 ---Date of Invoice : 1/24/2005 I(IIIIII IIIIII III IIIII IIIII IIIII VIII VIII VIII IIIII IIIII IIIII IIII IIIIII VIII IIII IIII <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZ AT FEE $ 405.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 629.00 <br /> Payment Due Date 2/ 005 <br /> TOTAL DUE this Billing Period _ �629.00 <br /> PAYMENT <br /> RECEIVED <br /> JAN 3 1 2005 <br /> SAN JOAQUIN COUNTY <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 i 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?ji.rpt <br />