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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0027262 <br /> Facility ID FA0015738 <br /> Date Printed 10/21/2004 <br /> ZIEGFRIED, ROBERT O RE : FORMER OXY CHEM <br /> CRA L. 16777 HOWLAND RD <br /> 202 VAL DERVIN PKWY STE #400 LATHROP, CA 95330 <br /> STOCKTON, CA 95206 <br /> OWNER : JR SIMPLOT CO <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0124362---Date of Invoice: 9/22/2004 I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> Hrs Employee <br /> 8/5/2004 2960 315-REPORT REVIEW 0.50 KNOLL $ 46.50 <br /> 8/9/2004 2960 312-CONSULTATION 0.50 KNOLL $ 46.50 <br /> 8/11/2004 2960 310-FIELD CONSULT 2.50 KNOLL $ 232.50 <br /> 8/13/2004 2960 310-FIELD CONSULT 1.50 KNOLL $ 139.50 <br /> 8/16/2004 2960 310-FIELD CONSULT 1.50 KNOLL $ 139.50 <br /> 8/17/2004 2960 310-FIELD CONSULT 1.00 KNOLL $ 93.00 <br /> Total for this Invoice $ 697.50 <br /> Payment Due Date 10/23/2004 <br /> TOTAL DUE this Billing Period $ 697.50 <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 "5 Days after the Invoice Date 60 Days afte•+he Invoice Date and each 30 Days thereafter <br /> 5255.rpt <br />