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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEP TM' �T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95 <br /> <br /> INVOICE AccountlD AR0016386 <br /> Facility ID FA0009386 <br /> Date Printed 3/2/2004 <br /> KS SOLUTIONS RE : KS SOLUTIONS <br /> PO BOX 504 28135 E COPPEROPOLIS RD <br /> ELVERTA, CA 95626 FARMINGTON, CA 95230 <br /> OWNER : FIELD, DAVID <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0117449---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 HA2MAT FEE $ 85.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 309.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 309.00 <br /> �F <br /> PAY E N_,' <br /> RECEIVES <br /> MAR 2 2 2001 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> Please make Checks AYABLE to: 'EHD' -- Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fes 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 />