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"AN JOAQUIN COUNTY <br /> :NVIRONMENTAL HEALTH DEPARTMEO • Page 1 <br /> 104 E WEBER AVE -3RD FLOOR <br /> >TOCKTON, CA 95202 <br /> )hone: (209)468-3420 <br /> INVOICE Account ID AR0020305 <br /> LMEMBOMMEMEMMMA <br /> Facility ID FA0012448 <br /> Date Printed F 6/27/2003 <br /> WILD ROSE VINEYARDS RE :WILD ROSE VINEYARDS <br /> P.O. BOX 298 8751 E HWY 12 <br /> VICTOR, CA 95253 VICTOR, CA 95253 <br /> OWNER :R LAWSON ENTERPRISES <br /> Dale Health , <br /> Program Description Amount <br /> Invoice# IN0104344—Date of Invoice: 2/27/2003 <br /> 2/27/2003 2214 CaIARP FAC STATE SURCHARGE FEE $ 200.00 <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 330.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> 4/15/2003 9987 Haz Mal Program Penalty Fee $ 33.00 <br /> Total for this Invoice $ 580.50 <br /> PAST DUE <br /> PAST UE! TOTAL DUE this Billing Period $ 580.50 <br /> WE WOULD APPRECIATE YOUR <br /> PAYMENT TODAY! <br /> PAST D 9%1J, <br /> Delinquent charges <br /> will be forwarded tn <br /> C 0 L L F-0 T 1Q'iiN <br /> in 30 days. <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 all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10 <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5255.rpt <br />