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tNVIFIUNI'OIitNIHLF1tHLIf1uL'7- &r\ X141 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> low <br /> INVOICE Account ID AR0020959 <br /> Facility ID FA0012658 <br /> Date Printed --4/3/2006•-- <br /> MARTINEZ, GEO GE RE : BACK ROADS CUSTOM CYCLE <br /> BACK ROADS C STOM CYCLE 7939 E 11TH ST <br /> 7939 E 11TH ST TRACY, CA 95304 <br /> TRACY, CA 9530 <br /> OWNER : MARTINEZ, GEORGE <br /> Date Health <br /> Program Descripti n Amount <br /> Invoice# IN0143209---Date of Invoice: 1/27/2006 11111111111111 III VIII VIII VIII VIII VIII VIII VIII VIII VIII 111111111111111 IIII IIII <br /> 1/27/2006 2220 SM HW MEN<5 TONSNR $ 200.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 224.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 224.00 <br /> V <br /> PAYMENT <br /> RECEIVED <br /> APk 0 3 Zoos <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 For OES/HMMP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Feel 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 /> 5254.rpt <br />