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Page 1 <br />INVOICE AR0004234Account ID <br />FA0004505 <br />Facility ID <br />5/23/01Date Printed <br />OWNER : SJC UTILITIES MAINT DIST <br />HrsDate Employee Amount <br />5/22/2001 Public Water System EH Annual Operating Permit Fee4622 <br />$415.00 <br />Please make Checks PAYABLE to : PHS/EHD I <br />5255.rpt <br />SAN JOAOUIN COUNTY PUBLIC i.^ALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />304 E WEBER AVE - 3RD FLOOR <br />STOCKTON. CA 95202 <br />209-468-3420 <br />Penalties will be added to all Permit Fees <br />at the Rate of 100% of the Base Fee <br />30 Days after the Due Date <br />SAN JOAQUIN CO UTIL MAINT DIST <br />FAIROAKS PWS #44 <br />1702 E SCOTTS AVE <br />STOCKTON CA 95205 <br />RE: FAIROAKS PWS #44 <br />FAIROAKS/BATES RD <br />TRACY CA 95376 <br />Return a Copy of This STATEMENT with Your PAYMENT <br />For all SERVICE FEES <br />Penalties will be added at the Rate of 10% <br />60 Days after the Invoice Date and each 30 thereafter <br />$415.00 <br />$415.00Total for this lnvoice| <br />Payment Due Date <br />TOTAL DUE this Billing Period| ~ <br />Health <br />Program Description <br />Invoice # IN0084813 — Date of Invoice : 5/22/01