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0AN JVP%WUIN t UUN I T <br /> ENVIRONMENTAL HEALTH DEPART . Page 1 <br /> 304 E WEBER AVE -3RD FLOOR ' <br /> STO 95202 COPY <br /> Phone:e: (209(209) 46468-3420 <br /> INVOICE AccountlD AR0016439 <br /> Facility ID I FA0009439 <br /> Date Printed1/26/2007 <br /> INEMENNUMOMMEMA <br /> SCHIPPER, LOUIS RE : CEMEX CONST MATERIALS - FRENCH <br /> CEMEX CONST MATERIALS - FRENCH CAMP CAMP <br /> 5180 GOLDEN FOOTHILL PARKWAY 899 E ROTH RD <br /> EL DORADO HILLS, CA 95762 FRENCH CAMP, CA 95231 <br /> OWNER : CEMEX CONSTRUCTION MATERIAL LP <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN01 56562--Date of Invoice: 1/25/2007 IIIIIIIIIIIIIIIVIIVIIIVIIVIVIIIVIIVIIVIIIVIIIIIIIIIIIIIIIIIIIIII <br /> 1/25/2007 2220 SM HW GEN c5 TONS/YR $ 206.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total forthis Invoicel $ 230.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 230.00 <br /> T— <br /> A�Y <br /> /�'Fc�M�cctJT <br /> FF9 2 O <br /> S �o�QU 2001 <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 DES 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 />