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SAN JOAQUIN COUNTY ENVI ONM--TTAL HEALTH DEPARTMENT Page 1 <br /> 304E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0020959 <br /> Facility ID FA0012658 <br /> Date Printed 3/28/2002 <br /> MARTINEZ,GE RGE RE : BACK ROADS CUSTOM CYCLE <br /> BACK ROADS C1 JSTOM CYCLE 7939A W 11TH ST <br /> 7939A E 11TH ST TRACY CA 95304 <br /> TRACY CA 95304 <br /> OWNER: MARTINEZ,GEORGE <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0091564---Date of Invoice: 1/22/2002 <br /> 1/22/2002 2220 SM HW GE N<5 TONSNR $200.00 <br /> 1/22/2002 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $17.50 <br /> Total for this Invoice $217.50 <br /> Payment Due Date 1377 <br /> TOTAL DUE this Billing Periodl /$217.50 <br /> Please make Checks PAYABLE to: EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be addedto all Permit Fees For all SERVICE FEES <br /> at the Rite of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> i�AST DUE! <br /> WE WOULD APPRECIATE YOUR <br /> PAYMENT TODAY! <br /> PAYMENT <br /> RECEI\/E® <br /> APR 122002 <br /> SAN JOAQUIN COUNTY <br /> PUBLICO HEALTH SERVICES <br /> ENVIRONMENTA HEALTH DIVISIOW <br /> 5255.rpt <br />