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SAN JOAOUIN COUNTY PUBLI(JOALTH SERVICES i Page 1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> 209468-3420 <br /> INVOICE AccountlD AR0017273 <br /> Facility ID FA0010273 <br /> Date Printed 2/1/01 <br /> LICENSING RE : COSTCO WHOLESALE-MEATS#210 <br /> COSTCO WHOLESALE#210 25701 S CORPORATE CT <br /> <br /> OWNER: COSTCO WHOLESALE CORP <br /> Health <br /> Date Program Description His Employee Amount <br /> Invoice# IN0080542--Date of Invoice: 1/30/01 <br /> 1/30/2001 2220 SM HW GEN<5 TONS/YR $100.00 <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $110.00 <br /> Payment Due Date 2001 <br /> TOTAL DUE this Billing Period $110.00 <br /> Please make Checks PAYABLE to: PHS/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 Penal ties 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 /> PAYMENT <br /> RECEIVED <br /> FEB 1 6 2001 <br /> 9AN JCk� ",d OOL14iY <br /> 5255.rpt <br />