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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART 'NT „/Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> S f3CKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0000195 <br /> Facility ID FA0000196 <br /> Date Printed 1/24/2005 <br /> {gg�•gGMMWGs <br /> RE : LODI USD-TOKAY HIGH SCHOOL <br /> LODI UNIFIED SCHOOL DIST 1111 CENTURY BLVD <br /> 1305 E VINE ST LODI, CA 95240 <br /> LODI, CA 95240 <br /> OWNER : LODI UNIFIED SCHOOL DIST <br /> Health <br /> Date Prog,ar, Description <br /> Invoice# IN01 28959—Date of invoice : 1/24/2005 1111111111 HE11111111p111111p11pp11p11pp11p111p111p1IN <br /> 1/24/2005 2220 SM HV/GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 270.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 494.00 <br /> Payment Due Date 2312 <br /> TOTAL DUE this Billing Period $ 494.00 <br /> PAYMENT <br /> RECEIVED <br /> MAR 1 6 2005 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <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/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 /> _—rpt <br />