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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM' Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0028812 <br /> Facility ID FA0016372 III <br /> Date Printed 1/30/2006 <br /> MICHAEL D SCOTT RE : STOCKTON INDUSTRIAL SUPPLY <br /> STOCKTON INDUSTRIAL SUPPLY 336 S AURORA ST <br /> 536 S AURORA ST STOCKTON, CA 95205 <br /> STOCKTON, CA 95205 <br /> OWNER : SCOTT, MICHAEL D <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0144731 ---Date of Invoice: 1/27/2006 111111 111 11111 IN 11111 11111 11111 11111 11111 11111 11111 IN 11111 11111 1111 1111 <br /> 1/27/2006 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 224.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 224 0 <br /> R �N r <br /> �d <br /> F <br /> j SAN EB 2 1 2006 <br /> 1 <br /> JO' QUIP,' <br /> H ENV/RONM `'Otj/v <br /> EACTy D�pARTM�NT <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 OES/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 />