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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMEI- - <br />304 E WEBER AVE 3RD FLOOR <br />STOCKTON, CA 9520.2 <br />Phone: (209) 468-3420 <br />INVOICE <br />WALMART #1789 <br />702 SW EIGHTH ST <br />BENTONVILLE, AR 72716-0500 <br />Qy� <br />Account ID PR0009063 <br />Facility ID FA0006691 <br />Date Printed 1I30120D6 <br />RE: WALMART #1789 <br />.2350 W KETTLEMAN LN <br />LODI, CA 95242 <br />OWNER: WALMART, INC <br />f pate Health <br />{ Program Description <br />Invoice # ING143220 — Date of Invoice : 1/2712006 <br />1/27/2006 2220 SM HW GEN <5 TONSNR <br />1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />Amount <br />11111111111111111 Illll 11111 lllil IIi111111111111 IIf 11 IIIII Illll 1111 111111 11111 If111111 <br />$ 200.00 <br />$ 24.00 <br />r Total for this Invoice $ 224.00 <br />Payment Due Date 3/1/2006 <br />TOTAL DUE this Billing Period $ 224.00 <br />PAYMENT <br />FEB 13 2 <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 OES / 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 />