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JAN JUAUUIN UUUIV I Y <br /> ENVIRONMENTAL HEALTH DE ARTPO-NT Page 1 <br /> 600 E MAIN STREET _ <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0023280 <br /> Facility ID FA0013833 <br /> Date Printed 1/29/2009 <br /> BRYAN TEVES RE : WILSON & COFFEY APPLIANCES <br /> WILSON &COFF Y APPLIANCES 2617 S EL DORADO ST <br /> 2617 S EL DORA O ST STOCKTON, CA 95207 <br /> STOCKTON, CA '95206 <br /> OWNER : PHILLIPS, LEON R <br /> Date Health <br /> Program Descript on Amount <br /> Invoice# IN0185635---Date f Invoice 1/29/2009 <br /> I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> 1/29/2009 2220 SM HW SEN<5 TONS/YR $ 213.00 <br /> 1/29/2009 2399 UNIFIES PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 237.00 <br /> Payment Due Date 2/28/2009 <br /> TOTAL DUE this Billing Period $ 1137.06 <br /> PA` N"P INT <br /> FEB 0 6 2009 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> 7 HEALTH DEPARTMENT <br /> � I <br /> Please make Checks YABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fee For OES/HMMP Fees For all SERVICE FEES <br /> at the Rate of 100%of the B se 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 to 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> ;2�4.rpt <br />