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SAN J(�UIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTNW Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0016927 <br /> INVOICE <br /> Facility ID FA0009927 <br /> Date Printed 2/12/2015 <br /> CLARK, JAMES & ELISA RE : TRANS AMERICAN INC <br /> TRANS AMERICAN INC 1838 VICKI LN <br /> <br /> <br /> OWNER : TRANS AMERICAN INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0259698---Date of Invoice: 1/2912015 (IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> Hrs Employee <br /> 12/18/2014 2220 333-INSPECTION/REINSPECTION(1 hr minimum) 2.00 WONG $ 260.00 <br /> Total for this Invoice $ 260.00 <br /> Payment Due Date 2/2812015 <br /> Invoice# IN0261149---Date of Invoice: 1/2912015 IIIIIIIIIIIIIIIIIVIII(IIIIVIII(IIIIVIIIVIIIVIIIVIIIIIIIIIIIilllllllllllllllllll <br /> 1/29/2015 1921 HMBP-Regular-Primary.Loc4iion / $ 270.00 <br /> 1/29/2015 2220 SM HW GEN<5 TONSNR _-� f`� � S ( $ 213.00 <br /> 1/29/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total forthis Invoice I $ 518.00 <br /> Payment Due Date 2/28/2015 <br /> TOTAL DUE this Billing Period $ 778.00 <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 HMBP 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 />