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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONP!ENT.'.L HEALTH DEPARTP VT <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Amount to AR0016291 <br /> Facility ID F FA0009291 <br /> LUMMIMMMMONNINA <br /> Date Printed F 2/27/2003 <br /> LUMMEMMMMENNINNN <br /> TED'S WELDING & REPAIR RE : TED'S WELDING & REPAIR <br /> P.O. BOX 726 8932 E HWY 12 <br /> VICTOR, CA 95253 VICTOR, CA 95253 <br /> OWNER : G WILLIAM BRAUN <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0103400--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 $ 300.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Invoice $ 517.50 <br /> Payment Due Date 3/29/2003 <br /> TOTAL DUE this Billing Period $ 517.50 <br /> PAYMENT <br /> RECEIVED <br /> M8R 1 1 2003 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONI.".mre �1,i <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 />