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<br />3 3 <br />Account ID <br />Facility ID <br />Date Printed <br />Page 1 <br />RrO <br />ro I LJ )(VIP <br />AR0001720 <br />FA0001721 <br /> <br />2/27/2004 <br />RE: TRAVO-TEL MOTEL <br />2305 S EL DORADO ST <br />STOCKTON, CA 95206 <br />OWNER: GARDELLA, JOE ESTATE <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTM — T <br />304 E WEBER AVE - 3RD FLOOR <br />9. <br />STOCKTON, CA 95202 <br />Phone: (209) 468-3420 <br />INVOICE <br />RALPH LEE WHITE <br />TRAVO-TEL MOTEL <br />2230 S AIRPORT WY <br />STOCKTON, CA 95206 <br />Date Health <br />Program Description Amount <br />Invoice # IN0113002 --- Date of Invoice : 11/18/2003 <br />11/18/2003 3699 OUT OF SERVICE POOL/SPA 105.00 <br />1/7/2004 9999 PAYMENT ($ 105.00) <br />2/13/2004 9003 RETURN CHECK FEE 28.00 <br />2/15/2004 9998 CORRECTION TO A PAYMENT 105.00 <br />2/17/2004 9003 RETURN CHECK FEE 4.05 <br />Total for this Invoice 137.05 <br />PAST DUE <br />PAST DUE! <br />WE WOULD APPRECIATE YOUR <br />PAYMENT TODAY! PA citst4. a 137 .c.c <br />P A`"Evi- BEcENE D <br />NIPA 17 '1'3134 couN oPsou'' NmE34-' wilvto MEW- E DEADA <br />TOTAL DUE this Billing Period -137.05 <br /> <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% <br /> <br />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 />5255.rpt