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SAN JOAQUIN COUNTY • <br /> ENVIRONMENTAL HEALTH DEPARTMO Page 1 <br /> 600E MAIN STREET COPY <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0036209 <br /> Facility ID I FA0020278 <br /> Date Printed 1/30/2012 <br /> LUMMEMMOMMOMMa <br /> HENRY, WANE RE : UNITED RENTALS <br /> UNITED RENTALS 2911 E FREMON_IM <br /> PO BOX 5221 STOCKTON, CA 95205 <br /> MODESTO, CA 95352 <br /> OWNER : HENRY, WAYNE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0222922—Date ofInvoice: 1/27/2012 IIIIIIIIIIIIIINIIIIIIIIIIIVIVIIIIIIIIIIIIIIIIIIIIIIIIIVIIIIII <br /> His Employee <br /> 12/5/2011 2953 315-REPORT REVIEW 1.00 DUNCAN $ 125.00 <br /> 12/5/2011 2953 315-REPORT REVIEW 0.50 HENDERSON $ 62.50 <br /> 12/6/2011 2953 315-REPORT REVIEW 2.00 HENDERSON $ 250.00 <br /> 12/7/2011 2953 315-REPORT REVIEW 1.00 HENDERSON $ 125.00 <br /> 12/12/2011 2953 315-REPORT REVIEW 2.50 HENDERSON $ 312.50 <br /> 12/13/2011 2953 315-REPORT REVIEW 2.00 HENDERSON $ 250.00 <br /> 12114/2011 2953 315-REPORT REVIEW 1.50 HENDERSON $ 187.50 <br /> Totelfor thislnvoice $ 1,312.50 <br /> Payment Due Date 12012 <br /> TOTAL DUE this Billing Period 1 1,312.5$ 0 <br /> Z. b <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 2012 <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 />