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SAN JOAQUIN COUNTY <br /> ENVPRONMENTAL HEALTH DEPARTM( • Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0018053 <br /> Facility ID FA00110 3— <br /> LMMMMMEMMMMEM <br /> Date Printed 2/27/2006 <br /> CHAMPION RE : CHAMPION <br /> 1301 N EUCLID AVE 1220 VANDERBILT CIR <br /> PRINCETON, IL 61356 MANTECA, CA 95336 <br /> OWNER : GARDNER DENVER INC <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0143157---Date of Invoice: 1127/2006 111111111 IN <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 315.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total forthis Invoicel $ 539.00 <br /> Payment Due Date 3117 <br /> TOTAL DUE this Billing Period $ 539.0 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 7 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 I 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 /> 5254.rpt <br />