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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMc"'T <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0023136 <br /> Facility ID FA0013764 <br /> Date Printed 5/27/2009 <br /> A SAMBADO& SON INC RE : A SAMBADO & SON 39-370 <br /> A SAMBADO& SON 39-370 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 /> Program Description Amount <br /> Invoice# IN0191056---Date of Invoice: 5/26/2009 11111111 Ell1111111111111111111111111111 U111111111111111111111111111111111111IN <br /> Firs Employee <br /> 4/9/2009 2765 R28-OCCUPANCY RE-INSPECTION 0.60 RIVERA $ 63.00 <br /> 4/21/2009 2765 R28-OCCUPANCY RE-INSPECTION 0.40 RIVERA $ 42.00 <br /> Total for this Invoice $ 10 .00 <br /> Payment Due Date 6/26 009 <br /> TOTAL DUE this Billing Period $ 105 00 <br /> PAYI\J1ENT <br /> RECEIVED <br /> JUN 4 2009 <br /> SAN JOAQUIN COUNTY <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 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 />