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S -0 IN COUNTY <br /> EP4E <br /> MENTAL HEALTH DEPARTP' -IT Page 1 <br /> 3WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Accountll) AR0022882 <br /> Facility ID FA0013690 <br /> Date Printed <br /> KENNETH W ANDERSON RE : CEN CAL ROCK AND READY MIX <br /> CEN CAL ROCK AND READY MIX 904 E FRONTAGE RD <br /> PO BOX 683 RIPON, CA 95366 <br /> RIPON, CA 95366 <br /> OWNER : ANDERSON, KENNETH W <br /> Date Health <br /> o.,,,,ram np-r.rintlnn Amount <br /> Invoice# IN0104183---Date of Invoice: 2/27/2003 <br /> 2/27/2003 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Invoice $ 217.50 <br /> Payment Due Date 3/29/2003 <br /> TOTAL DUE this Billing Period $ 217.50 <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 Days thereafter <br /> 5255.rpt <br />