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FSANAQUIN COUNTY Page 1 <br /> NMENTAL HEALTH DEPARTII 0EBER AVE - 3RD FLOOR <br /> TON, CA 95202(209) 468-3420 (/ l(vLn] <br /> INVOICE AccountlD AR0016543 <br /> Facility ID FA0009543 <br /> LUMMMENNOMMIM <br /> Date Printed F2/27/2004 <br /> IMENNEENNEEMMMd <br /> A-1 TRANSMISSIONS RE : A-1 TRANSMISSIONS <br /> 3132 N WILSON WAY 3132 N WILSON WAY <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : GOODMAN, ERIC <br /> Data Health Amount <br /> Program Description <br /> Invoice# IN0115707---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 85.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 309.00 <br /> Payment Due Date 3/66 <br /> TOTAL DUE this Billing Period $ 309.00 <br /> PAYMENT <br /> RECEIVED <br /> MAR 16 2004 <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/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 /> 5255.rpt <br />