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SAN JOAOULN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH EPARTMENT <br /> 304 E WEBER AVE-3RD FLC OR (C(ap STOCKTON. CA 95202 <br /> Phone: 209-468-3420 <br /> INVOICE Account ID AR0002682 <br /> Facility ID FA0003118 <br /> Date Printed 2/5/2002 <br /> LONGS DRUG TORE#492 RE: LONGS DRUG STORE#492 <br /> PO BOX 5010 1122 W 11TH ST <br /> ANTIOCH CA 4531-5010 TRACY CA 95376 <br /> OWNER: LONGS DRUGSTORES,INC <br /> Health _ <br /> Date Progmrn Description Hrs Employee Amount <br /> Invoice# IN0090587---Date of Invoice: 1/22/2002 <br /> 1/22/2002 2399 UNIFIED OGRAM FAC STATE SERVICE FEE $17.50 <br /> 1/22/2002 2220 SM HW G EN<5 TONS/YF $200.00 <br /> Total for this Invoice $217.50 <br /> Payment Due Date 02 <br /> TOTAL DUE this Billing Period $217.50 <br /> Please make Checlis PAYABLE to: EHD / Return a Copy of This STATEMENT with Your PAYMEN <br /> Penalties will be added to all Permit Fees For all SERVICE FEES <br /> at the Rate of 10011.of the Base Fee Penalties will be added at the Rate of 10-/0 <br /> 30 Days after I he Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> AAR 4 2UJ2 <br /> S;;PJ JUAUUIN Co uli i v <br /> '"ri IC t'�^'TH''FRVICCS <br /> 5255.rpt <br />