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bAN JUAQUIN COUNTY <br /> ' ENVIRONMENTAL HEALTH DEPART'SVT ' '' <br /> 600 E MAIN STREET Page 1 <br /> L.� <br /> STOCKTON, CA 95202 <br /> Phone: (209).468-3420 COPY <br /> .L <br /> INVOICE Account ID AR0000331 <br /> Facility fD1=.00000332 <br /> Date Printed 5/24/2007 <br /> FORD, PAULRE : VILLA CEREZOS <br /> VILLA CEREZOS, 12348 N HWY 99 <br /> 12901 TRIPOLI CT LODI, CA 95240 <br /> LOS ALTOS, CA 94022 <br /> OWNER : FORD, PAUL & LOIS <br /> Date Health <br /> Program Description <br /> Amount <br /> Involce# IN0162153—Date of Invoice::5/2312007 - � � I I!!illllllllllll!!Illl(!1l11111I11lIII[!!!ll!l111111[ll[lllllflllllllll!l111!lllll[l <br /> f " <br /> 5/23/2007 4242 WASTE WATER TX PLANT $ 470.00 <br /> 5/23/2007 4622 25-99 SERVICE CONNECTIONS(CWS) $ 491.00 ' <br /> Total far this Involce $ 961.00 <br /> Payment Due Date 612 7 <br /> r• . <br /> TOTAL DUE this Billing Period $ 961.00 <br /> ') <br /> �ECE1 <br /> sUN 4 goo, <br /> E; ypp,QUIN CpUNN <br /> SANNVIFIONMeNTAL <br /> "EALIVIIDEPPIR"f t`IT <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 1 HMMP Fees For all SERVICE FEES <br /> at the Rete of 1o0%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 />