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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTP 'T 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 <br /> Date Printed 8/16/2005 <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# IN0136207---Date of Invoice: 8/16/2005 11111 11111 11111 11111 IN 111111 11111 IN 1111 <br /> 8/15/2005 9996 APPLY DISCOUNT ($ 100.00) <br /> 8/16/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> Total for this Invoice $ 100.00 <br /> Payment Due Date 9/15/2005 <br /> TOTAL DUE this Billing Period $ 100.00 <br /> -'4Y►Uj�rJ�.. <br /> ;�FcEI u�D <br /> AUG 19 200,E <br /> `JO'AQUIN COUNTY <br /> E'NVIRONMEN7Aj <br /> L <br /> HEALTH DEpART(VIEly <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 /> 5255.rpt <br />