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SAN JOAQUIN COUNTY �� it Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMr''T <br /> 304 E WEBER AVE-3RD FLOOR '6 <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID <br /> AR0019074 <br /> # Facility ID FA0012021 <br /> l I Date Printed 4/25/2005 <br /> i� <br /> WESTERN SQUARE INDUSTRIES INC RE : WESTERN SQUARE INDUSTRIES INC <br /> 1621 N BROADWAY AVE [ 1621 N BROADWAY AVE <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> IIR <br /> OWNER : WESTERN SQUARE INDUSTRIES INC <br /> Date Health <br /> Program Description j Amount <br /> Invoice# iN0132395—Date of Invoice: 4/25/2005 if I��Il l ll�f�lll l��I if 111 lill'lll��lf l��lllll lull lll�l ll�f l�ll ll'll�l 111 llll�l�l <br /> Hrs Employee <br /> r <br /> 4/22/2005 3030 310-FIELD CONSULT 4.10 INF�URNA $ 381.30 <br /> Total for this Invoice $ 381.30 <br /> jPayment Due Date 5/2512005 <br /> I 'l <br /> TOTAL DUE this Billing Perlodk $ 381.30 <br /> kl i <br /> I iE I'F <br /> I� I <br /> '!LI <br /> Please make Checks PAYABLE to: 'EHD' - Return a Copy of This STATEMENT with Your PAYMENT <br /> �i <br /> Penalties will be added to all Permit Fees For OES 1 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% lPenalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 45 Days after the Invoice Date 60 Daysl6fter the Invoice Date and each 30 Days thereafter s <br /> 5255.rpt E <br />