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SprN JOAQUIN COUNTY PUBLIC HF' LTH SERVICES <br />+ ENVIRONMENTAL HEALTH DIVIL <br />304 E WEBER AVE - 3RD FLOOR <br />STOCKTON, CA 95202 <br />209-468-3420 <br /> <br /> <br /> <br /> <br />INVOICE <br />Page 1 <br />Account ID AR0016621 <br />Facility ID FA0009621 <br />Date Printed 4/25/00 <br />RE: JACK RABBIT <br />471 INDUSTRIAL AVE <br />RIPON CA 95366 <br />OWNER: EARL M ANDERSON <br />Health <br />Date Program Description Hrs Employee Amount <br />Invoice # IN0070260 --- Date of Invoice : 4/19/00 <br />4/19/2000 2220 SM HW GEN <5 TONSNR <br />4/19/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE <br />5255. rpt <br />$100.00 <br />$10.00 <br />Total for this Invoice $110.00 <br />Payment Due Date 5/25/2000 <br />TOTAL DUE this Billing Period $110.00/ <br />Please make Checks PAYABLE to: PHS/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 thereafter <br />It n <br />SAN JOAMIN COUNTY <br />PUBLIC HEALTH SERVICES <br />NVIRONMFATAL HEALTH DIVISION <br />