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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTIV'VT <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0019321 <br /> Facility ID I FA0012087 <br /> Date Printed F 11/5/2004 <br /> MIKE V LACH RE : FORD CONSTRUCTION CO <br /> FOOTHILL ENGINEERING 18846 N HWY 99 FRONTAGE RD <br /> 8442 STORY RIDGE WAY LODI, CA 95240 <br /> ANTELOPE, CA 95843 <br /> OWNER : FORD CONSTRUCTION <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0125132---Date of Invoice: 10/25/2004 II II I I I V I VIIIVII V I VIII I I IIII VI VIII I I III 11111 1111 IN <br /> Hrs Employee <br /> 9/14/2004 2960 315-REPORT REVIEW 1.00 KNOLL $ 93.00 <br /> 9/15/2004 2960 310-FIELD CONSULT 2.00 KNOLL $ 186.00 <br /> Total for this Invoice $ 279.00 <br /> Payment Due Date 11/24/2004 <br /> TOTAL DUE this Billing Period $ 279.00 <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 /> i?ji iP1 <br />