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alAN .JUHWU1114 I.UUIV 1 T <br /> ENVIRONMENTAL HEALTH DEPARTMI# Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 COPY <br /> INVOICE Account ID AR0004177 <br /> Facility ID F FA0004495 <br /> Date Printed F-1/-3 0—/2-0-0 6 <br /> RO LAB AMERICAN RUBBER CO RE : RO LAB AMERICAN RUBBER CO <br /> PO BOX 450 8830 W LINNE RD <br /> TRACY, CA 95378-0450 TRACY, CA 95304 <br /> OWNER : RO LAB AMERICAN RUBBER CO INC <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0142507---Date of Invoice: 1/27/2006 111111111 IN <br /> 1/27/2006 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 390.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 614.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 614.00 <br /> "T:—:C'E1V—E-Q <br /> MAR 0 8 2006 <br /> SAN JOAQUIri COUn,Ty <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 />