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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTN T Page 1 <br /> 600 E MXSTREET ' <br /> ST <br /> <br /> Account ID AR0004351 <br /> Facility ID PAOL56 <br /> Date Printed 1 8/25/2009 <br /> DIDAR S RANDHAWA RE : CHEROKEE LANE SERVICE STATION* <br /> CHEROKEE LANE SERVICE STATION* 900 S CHEROKEE LN <br /> 900 S CHEROKEE LN LODI, CA 95240 <br /> LODI,CA 95240 <br /> OWNER : RANDHAWA, DIDAR SINGH <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0192344-Date of Invoice: 7/27/2009 11I[]111111111111111 IN IN <br /> Hrs Employee <br /> 6/22/2009 2361 306-FOLLOW UP FOR NON-COMPLIANCE 0.50 CACAPIT $ 52.50 <br /> 6/22/2009 2220 306-FOLLOW UP FOR NON-COMPLIANCE 0.50 CACAPIT $ 5 <br /> ,�:C ; I E F r <br /> Total for this Invoice $ 105.00 <br /> 10 " (_ i r r ;' Payment Due Date <br /> Invoice# IN0192806--Date of Invoice: 8/24/2009 l/111/1/IIIIII III VIII VIII VIII VIII VIII VIII VIII IIIII1lII IIIIII VIII I'll IIII <br /> Hrs Employee <br /> 7/31/2009 2361 306-FOLLOW UP FOR NON-COMPLIANCE 0.20 CACAPIT $ 21.00 <br /> 7/31/2009 2220 306-FOLLOW UP FOR NON-COMPLIANCE 0.20 CACAPIT $ 2 <br /> Total for this Invoice $ 42.00 <br /> Payment Due Date <br /> TOTAL DUE this Billing Period $ 147.00 <br /> PAYMENT <br /> RECEIVED <br /> OCT 0 2 2009 <br /> SAN JOACQUIN COUNTY <br /> ENVlqOt4MFNTHEA,Ljo DEPART E T <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 I 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 />