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S: 1 JS{�4QUIN COUNTY <br /> N�IR3 <br /> EMENTAL HEALTH DEPARTWT Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOQKTON, CA 95202 <br /> Phone: (209)1368-3420 <br /> INVOICE AcwunlID F AR0022739 <br /> Facility ID FA0013605 <br /> Date Printed 2/27/2003 <br /> TRACY DODGE CHRYSLER JEEP RE : TRACY DODGE CHRYSLER JEEP <br /> 3460 W NAGLEE RD 3460 NAGLEE RD <br /> TRACY, CA 95304 TRACY, CA 95376 <br /> OWNER : TRACY MOTOR CO <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0104096--Date of Invoice: 212712003 <br /> 2/27/2003 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 130.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE 3 17.50 <br /> Total for this Invoice $ 347.50 <br /> Payment Due Date 3/29/2003 <br /> TOTAL DUE this Billing Period $ 347.50 <br /> PAYMENT <br /> RECEIVED <br /> MAR 1-0 2003 <br /> SAN JOAQUIN COUNTY <br /> ENl'IAUBLIC(INMFNTALLFEAE HTH VDIVI9^%N <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 all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5255.rpt <br />