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J' r. ci.r A: 1-4 -..u%,i: , <br /> tN riRONMENTAL HEAL1 H UEPARTMT • Page ', <br /> 304 E WEBE%2 AVE'-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE \\G�O Account ID AR0016439 <br /> Facility ID FA 00094 99 <br /> Date Pnnted 2/27/2003 <br /> AMERICAN TRANSIT MIX-TRACY RE : AMERICAN TRANSIT MIX- FRENCH CAMP <br /> 3407 W STUHR RD 899 E ROTH RD <br /> NEWMAN, CA 95360 FRENCH CAMP, CA 95231 <br /> OWNER : JERRY LARSEN <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0103459--Date of Invoice: 2/27/2003 <br /> 2/27/2003 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 450.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Invoice $ 667.50 <br /> Payment Due Date 3/ <br /> TOTAL DUE this Billing Period $ *66475j02) <br /> �61g910177�7 <br /> �r��9Z5Z tiZ G2��� <br /> PAYMENT <br /> RECEIVED <br /> MAR 10 2003 <br /> SAN JOAQUIN COLINTy <br /> PUBLIC HEALTH SERVICES <br /> E W'IRONWNTAL HEALTH OIVIS'ON <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 />