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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM� Page 1 <br /> 304 E U4c`BER AVE -3RD FLOOR <br /> SYOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0020415 <br /> Facility ID F FA00 2-503 <br /> Date Printed 2/5/2004 <br /> SAN JOAQUIN RIVER CLUB RE : SAN JOAQUIN RIVER CLUB <br /> 30000 KASSON RD 30000 KASSON RD <br /> TRACY, CA 95376 TRACY, CA 95376 <br /> OWNER : SAN JOAQUIN RIVER CLUB <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0116189---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoicel $ 224.00 <br /> Payment Due Date 3/1 <br /> TOTAL DUE this Billing Period $ <br /> i` <br /> *p9ya <br /> EC VEO <br /> �VB 19 2004 <br /> SAN 30 OUIN COUNTY <br /> NVIPONMENTAL <br /> HEEALTH 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 I I 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 /> 5255.rpt <br />