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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTIWT Page 1 <br /> 600E MAIN STREET COPY <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0028882 <br /> LEMOMMMMEMEMEN <br /> Facility ID FA0 116421 <br /> Date Printed 1/29/2009 <br /> <br /> <br /> TRACY, CA 95304 <br /> OWNER <br /> t��L�TV✓1CKr ANG <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0187024---Date of Invoice: 1129/2009 IIIIIIIIIIIIIIIIVIIIVIII VIIVIIIIIIIIIIIIVIII VIIIIIIIIIII IIIIII VIIIIIIIIIII <br /> 1/29/2009 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 237.00 <br /> Payment Due Date 2128/2009 <br /> TOTAL DUE this Billing Period $ 237.00 <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 I 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 />