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1 <br /> 07/21/2005_ 16.43 20676 2 FMH PAGE 01/01 <br /> ENVIRONMENTAL HEALTH DEPART Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)466-3420 <br /> `j n INVOICE Account 11) ARoo1760a <br /> (( � LL � Facility ID I FA0010604 <br /> Date Printed 1/24/2005 <br /> URBACH, BILL RE : YALE -PACIFIC INC <br /> YALE PACIFIC 2331 STAGECOACH DR <br /> 30361 WHIPPLE RD STOCKTON, CA 95215 <br /> UNION CITY, CA 94587 <br /> OWNER: YALE PACIFIC INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0128353--Date of Invoice: 112,412005 IIIIIIIIIIIIIIIII fllllllll IINI IIIIIII�I I�IBIIIIIINI�IINIIIIIIIIIIIIIII I1111 <br /> 1!2412005 2220 SM HW GEN c5 TONSNFZ $ 20000 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 145.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this In 9.00 <br /> Pa ment Due Date 2123!200 <br /> TOTAL DUE this Billing Period 69.00 <br /> �y z(12( <br /> YDS <br /> " Cg n L( <br /> PAYME-T <br /> RECEIVED <br /> FEB 2 4 2005 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> 14EALTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHD' - Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permlt Fees For DES!HMMP Fees For all SER=Rmtoof <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% Penalties wlll be add30 Days after the Due Date 45 Days abler the Invoice Date 60 Days after the Invoice Dat <br /> 5255.rpt <br />