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r • • <br /> SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 3ti4 E WEBER AVE-3RD FLOOR l <br /> STOCKTON. CA 95202 <br /> Phone: 209-468-3420 <br /> INVOICE Account ID AR0016439 <br /> ---T=aei1' FA0001439 <br /> Date Prints /5/2002 <br /> KURT A KEMMER RE: AMERICAN TRANSIT MIX <br /> AMERICAN TRANSIT MIX 899 E ROTH RD <br /> 318 BEARD AVE FRENCH CAMP CA 95231 20 <br /> MODESTO CA 95354 WNER: JERRY LARSEN <br /> Health i <br /> Date Program Description Hm Employee Amount <br /> Invoice# IN0091139—Date of Invoice: 1122/2002 <br /> 1/22/2002 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $17.50 <br /> 1/22/2002 2220 SM HW GEN<5 TONS/YF $200.00 <br /> Total for this Invoice $217.50 <br /> Payment Due Date /20 <br /> TOTAL DUE this Billing Period $217.50 <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 thereafter <br /> (aZ -T1_'0 1 <br /> �" / PAYNIEN- <br /> RECE��/Fr, <br /> SAN J6:,OWW L:�uNTY <br /> V PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 5255.rpt <br />