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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTI' T <br /> 304 E WEBER AVE -3RD FLOOR <br /> ST <br /> <br /> INVOICE Account ID AR0016026 <br /> Facility ID FA0009026 <br /> Da'e Printed 2/5/2004 <br /> LODI NEWS-SENTINEL RE : LODI NEWS-SENTINEL <br /> PO BOX 1360 125 N CHURCH ST <br /> LODI, CA 95241 LODI, CA 95240 <br /> OWNER : FRED MARTY &JIM WEYBRET <br /> Date Health <br /> I rlUl�.lglll Do-✓ii✓t�^ Amount <br /> Invoice# IN0115484---Date of Invoice : 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 330.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 554.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ !;' 554.00 `) <br /> 1 <br /> PAYMENT <br /> RECEIVED <br /> MAR 8 2004 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <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 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 />