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SAN _.OAQUIN COUNTY I Page 1 <br /> ENVIRONMENTAL HEALTH DEP,ARTM <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, <br /> <br /> Account ID AR0000355 <br /> Facility ID FA0000356 <br /> Date Printed j 2/5/2004 <br /> DAVID T PRICE I CRE : DAVID T PRICE INC <br /> 21657 E DODDS D 21657 E DODDS RD <br /> ESCALON, CA 95..320 ESCALON, CA 95320 <br /> OWNER : PRICE, DAVID T <br /> Health Amount <br /> Date Program Description <br /> Invoice# IN0115935---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW 9EN<5 TONS/YR S 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE S 405.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE S 24.00 <br /> Total for this Invoice S 629.00 <br /> Payment Due Date 3/612004 <br /> TOTAL DUE this Billing Period $ 629.00 <br /> PECE VES <br /> R <br /> FEB 7 200 <br /> SAN JOAQUIN CpU'`t'Y <br /> VIP,OP4v�I�rA` <br /> EN EPF,9 t iVti^NT <br /> EAtT�' <br /> Please make Checks AYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fe s �beadded <br /> P Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalthe 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 />