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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEl Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 96-202 <br /> Phone: (209) 468-3420 COPY <br /> INVQICE AccountlD RR0003672 <br /> loommmommmmma <br /> Facility ID F FA0004032 <br /> Date Printed 10/23/2007 <br /> Inumommoommmoa <br /> SMITH, TREVOR RE : AMERICAN MOULDING 8r MILLWORK <br /> MILL CREEK DEVELOPMENT (FRMR) <br /> 1313 W R HOOD-P,ST-E-A-9 2801 WEST LN <br /> STOP N_C161^ 209 7j STOCKTON, CA 95204 <br /> t- S+- Stn l c -S%� OWNER : LAZARES, DAVID <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0167007--Date of Invoice: 10/22/2007 IIIIIIIIIIIIII IIIVIIIIIIIIIIIIIVIII VIII VIII IIIIIIIIII IIII IIIIII VIII IIIIIIII <br /> Hrs Employee <br /> 9/25/2007 2959 315-REPORT REVIEW 1.00 GIRARDI $ 98.00 <br /> Total for this Invoice $ 98.00 <br /> Payment Due Date 11/22/2007 <br /> TOTAL DUE this Billing Period $ 98.00 <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> rnalties will be added to all Permit Fees For DES/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 /> 5254.rpt <br />