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NMENTAL HEALTH DEPARTMENT Paye 1 <br /> 3RD FLOOR <br /> -A 95202 <br /> /468-3420 <br /> INVOICE <br /> Account ID F AR0023182 <br /> Facility ID FA0013789 <br /> Date Pdnted 6/14/2002 <br /> IMOGENE BOWMAN RE : BOWMAN,IMOGENE <br /> 956 N AVALON <br /> BOWMAN, E 955 WHITE LN <br /> DDR R ' <br /> STOCKTON CA 95215 STOCKTON CA 95215 <br /> OWNER: BOWMAN,IMOGENE <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0096965--Date of Invoice: 6/14/2002 <br /> 6/14/2002 9900 UST TANK FEES 2001 Permit $500.00 <br /> 6/14/2002 9900 UST TANK FEES 2000 Permit $170.00 <br /> 6/14/2002 9900 UST TANK FEES 1999 Permit $170.00 <br /> 6/14/2002 9900 UST TANK FEES 1998 Permit $170.00 <br /> 6/14/2002 9900 UST TANK FEES 1997 Permit $170.00 <br /> 6/14/2002 9904 UST PENALTIES(TANK) 2001 Penalty $500.00 <br /> 6/14/2002 9904 UST PENALTIES(TANK) 2000 Penalty $170.00 <br /> 6/14/2002 9904 UST PENALTIES(TANK) 1999 Penalty $170.00 <br /> 6/14/2002 9904 UST PENALTIES(TANK) 1998 Penalty $17000 <br /> 6/14/2002 9904 UST PENALTIES(TANK) 1937 Penalty $170.00 <br /> 6/14/2002 9994 PERMIT FEE PENALTY 2002 Penalty $500.00 <br /> 6/14/2002 2362 Underground Storage Tank EH Operating Permit Fee 2002 Permit $500.00 <br /> 6/14/2002 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE 2002 $17.50 <br /> 6/14/2002 2301 UST STATE SURCHARGE 2QQ2 $10.00 <br /> Total for this Invoice $3,387.50 <br /> Payment Due Date 7/14/2002 <br /> TOTAL DUE this Billing Period $3,387.50 <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 thereafter <br /> 1267.rpf • • <br />