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JM11 OUM61UHM tJUU1V1 T <br /> ENVIRONMENTAL HEALTH DEPARTME"IT Page 1 <br /> 304 E WEBER AVE -3RD FLOORSTOCKv <br /> Phone: ON,209 46 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account 10 AR0017188 <br /> LoommmmmonomA <br /> Facility ID F FA0010188 <br /> Date Printed F 1/26/2007 <br /> Immommummmomomms <br /> ANTONINI <br /> <br /> , CA 95215 <br /> OWNER : ANTONINI, MARK & J; WHELLNER,K <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0166808--Date of Invoice: 1/2512007 111111111 Hill 11111111111111111111 Hill 1111111111 Hill 11111111 Hill 11111111 <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 375.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 605.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 605.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 o 2ou ,, <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEP.ggTMENT <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 DES I 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 />