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ENVIRONMENTAL HEALTH DEPARTMF...T rayc <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0003775 <br /> Facility ID FA0004113 <br /> Date Printed 4/5/2011 <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# IN0210200---Date of Invoice: 1/19/2011 11111111111111111111 IN IIII <br /> 1/19/2011 2765 EMPLOYEE HOUSING-PERMANENT>180 DAYS $ 155.00 <br /> 1/19/2011 9999 PAYMENT ($ 155.00) <br /> 4/5/2011 2765 EMPLOYEE HOUSING-PERMANENT>180 DAYS $ 60.00 <br /> Total for this Invoice $ 60.00 <br /> Payment Due Date 5/5/2011 <br /> TOTAL DUE this Billing Period $ 60.00 <br /> ppY� <br /> RV(; VEd <br /> pPR 21 2V <br /> SAN JOADUIN COUNN <br /> ENVIROMEN 1 M�,1T <br /> HLALYH ULNi�F <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 />