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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMIF Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0003775 , <br /> Facility ID FA0004113 <br /> Date Printed 6/28/2011 <br /> A SAMBADO & SON INC RE : A SAMBADO & SON 39-321 <br /> A SAMBADO & SON 39-321 14000 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# IN0217119---Date of Invoice: 5/25/2011 11111111111111111 IIE SIR 1111111111111 IIH 11111111 AM 1111�1111IN <br /> Hrs Employee <br /> 4/13/2011 2765 R28-OCCUPANCY RE-INSPECTION 0.90 VELOSO-CACAPIT $ 109.80 <br /> Total for this Invoice $ 109.80 <br /> Payment Due Date 6/25/2011 <br /> TOTAL DUE this Billing Period $ 109.80 <br /> pAYN1EhT <br /> RECEIdf. <br /> �uN 2 g 2011 <br /> y 'OAQUIN C- , <br /> ' ,,tY <br /> ENVIRONMEh �L <br /> HF,0.1.TH DEPAK`6�Et1T <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 /> ;?>4.rpt <br />