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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTME"� Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0023136 <br /> Facility ID FA0013764 <br /> Date Printed 4/28/2011 <br /> A SAMBADO & SON INC RE : A SAMBADO & SON 39-370iWTR SYS <br /> A SAMBADO & SON 39-370/WTR SYS 15294 E EIGHT MILE RD <br /> 8077 N TULLY RD LINDEN, CA 95236 <br /> LINDEN, CA 95236 <br /> OWNER : SAMBADO, LAWRENCE J & BEVERLY <br /> Date Health <br /> Proaram Description Amount <br /> Invoice# IN0215619---Date of Invoice: 4/27/2011 111111111111111111111111 IN <br /> Hrs Employee <br /> 3/30/2011 2765 R28-OCCUPANCY RE-INSPECTION 0.90 VELOSO-CACAPIT $ 109.80 <br /> Total for this Invoice $ 109.80 <br /> Payment Due Date 5/28/2011 <br /> TOTAL DUE this Billing Period $ 109.80 <br /> PAYMENT <br /> RECEIVF[., <br /> MAY 2 0 2011 <br /> -UN JOgnUI7 <br /> EN7tp.': <br /> HEALTH, <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 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 />