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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMr-"— Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID F AR0023280 <br /> Facility ID FA0013833 <br /> Date Printed 1 1/26/2007 <br /> amu® <br /> BRYAN TEVES RE : WILSON & COFFEY APPLIANCES <br /> WILSON & COFF Y APPLIANCES 2617 S EL DORADO ST <br /> 2617 S EL DORADO ST STOCKTON, CA 95207 <br /> STOCKTON, CA E 5206 <br /> OWNER : PHILLIPS, LEON R <br /> Date Health <br /> Program Descriptic n Amount <br /> Invoice# IN0158197---Date of Invoice : 1/25/2007 1111 111111 11111 1111 IN <br /> 1/25/2007 2220 SM HW C EN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2399 UNIFIED DROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 230.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 30.00 <br /> PA T <br /> '9E0'EI VEu <br /> FEB 0 2 2007 <br /> SAN JOAQUIN COUNIy <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <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 B�lse 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 /> �2-�4.rpt <br />