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SAN JOAQUIN COUNTY Page <br /> ENVIPZONMENTAL HEALTH DEPARIONT • <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> Account*lD AR0017146 <br /> INVOICE <br /> Facility ID FA0010146 <br /> Date Printed 2/27/2003 <br /> C&S ONE HOUR MARTINIZING RE : C&S ONE HOUR MiAR T iNiZiNG <br /> 5756 PACIFIC AVE#1 5756 PACIFIC AVE 1 <br /> STOCKTON, CA 95207 STOCKTON, CA 95207 <br /> OWNER : PATEL, CHARLES <br /> Health Amount <br /> n <br /> Date rogr-m Description <br /> Invoice# IN0103719--Date of Invoice: 2/27/2003 <br /> 2.127/2003 2220 SM HVV GEN<5 TONS/YR S 200.00 <br /> 2/27,2003 2244 2003 HMMP Annual Fee $ 255.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for thisInvoice $ 472.50 <br /> Payment Due Date 3/29/2003 <br /> TOTAL DUE this Billing Period $ 472.50 <br /> PAYMENT <br /> RECEIVED <br /> MAR 5 2003 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMFNTAL HEALTH DIVISION <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 />