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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMV • <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE A=unt ID AR0028741 <br /> Facility ID FA0016351 <br /> Date Printed 7/29/2005 <br /> MELVIN ROUSH RE : VALLEY VINEYARD & ORCHARD SUPPLY <br /> VALLEY VINEYARD & ORCHARD SUPPLY 420 N SACRAMENTO ST <br /> <br /> 1 `d�JI <br /> OWNER : ROUSH, MELVIN D t � <br /> V <br /> Date Health <br /> Program Description _ Amount <br /> Invoice# IN0135886---Date of Invoice: 7/29/2005 I IIIIIII IIIIII III VIII IIIII IIIII IIIII IIIII VIII VIII IIIII IIIII IIII IIIIII VIII IIII IIII <br /> 7/29/2005 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 7/29/2005 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this invoice $ 224.00 <br /> Payment Due Date <br /> TOTAL DUE this Billing Period 1 $ 224.00 <br /> PAYMENT <br /> RECEIVED <br /> AUG - 8 2006 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <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/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 /> 5255.rpt <br />