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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTI T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 9 <br /> <br /> R0003458 <br /> Facility ID l FA0003870 <br /> O Date Printed 8/24/2004 <br /> MUHAMMAD RIZ AN O RE : SRH FOOD & GAS <br /> SRH FOOD & GAS, 749 E CHARTER WAY <br /> 749 E CHARTER WAY �' " <br /> STOCKTON, CA 95206 <br /> STOCKTON, CA 95206 <br /> OWNER : RIZWAN, MUHAMMAD <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0123759---Date of Invoice : 8/24/2004 I IIIIIII IIIIII III VIII VIII IIIII IIIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> 8/24/2004 2220 SM HW G N<5 TONS/YR $ 200.00 <br /> Total for this Invoice $ 200.00 <br /> Payment Due Date 9/23/2004 <br /> TOTAL DUE this Billing Period $ 200.00 <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 /> 5255.rpt <br />