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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTML Page 1 <br /> 600E MAIN STREET COPY <br /> STOCKTON, CA 95202 <br /> Phone: (209468-3420 <br /> INVOICE Account ID AR0036209 <br /> Facility ID FA0020278 <br /> Date Printed F 2/29/2012 <br /> HENRY,WAYNE RE : UNITED RENTALS <br /> UNITED RENTALS 2911 E FREMONT ST <br /> PO BOX 5221 STOCKTON, CA 95205 <br /> MODESTO,CA 95352 <br /> OWNER : HENRY, WAYNE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0227051 —Date of Invoice: 2/2 812 01 2 IIIIIIIIIIVIIIIIVIVIVIIVIVII VIII VII//IIIIIVIIIIIIII <br /> Hrs Employee <br /> 1111/2012 2953 310-FIELD CONSULT 0.30 HENDERSON $ 37.50 <br /> 1123/2012 2953 315-REPORT REVIEW 1.00 HENDERSON $ 125.00 <br /> 1124/2012 2953 315-REPORT REVIEW 1.00 HENDERSON $ 125.00 <br /> 1125/2012 2953 315-REPORT REVIEW 1.50 HENDERSON $ 187.50 <br /> 1/26/2012 2953 312-CONSULTATION 1.00 DUNCAN $ 125.00 <br /> Total for this Invoice $ 600.00 <br /> Payment Due Date 3130/2012 <br /> `( f TOTAL DUE this Billing Period $ 600.00 <br /> /\\ll <br /> PAYMENT <br /> P,ECEIVED <br /> I,,., ; 1 - [012 <br /> SAN JOAQUIN COUNTY <br /> ENVIROMENTAL <br /> HEALTH DEPARTMENT <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 DES/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 />