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V/'ll\JVJ•1V(Vil\ LVVI\1 1 - <br /> ENVIRONMENTAL HEALTH DEPARTRIT f y Page 1 ; <br /> +800 E MAIN STREET !'-"� <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0004516 <br /> FacilitylD FA0002794 <br /> r <br /> Date Printed 8121/20D7 <br /> SHADOW LAKE MOBILE HOME PARK LLC RE : SHADOW LAKE MOBILE HOME PARK LLC <br /> 820 KAINS AVE#108 5100 N HWY 99 <br /> ALBANY, CA 94706 STOCKTON, CA 95212 <br /> OWNER <br /> Date Health <br /> Program Description Amount <br /> Involce# IN0165332—Date of Invoice: 8/17/2007 Illlllllllllll III IIIII!!Il1111111111111111Ell I 1i ME 1111111111111111111IIIE <br /> Hrs Employee i <br /> 7/18/2007 3611 333-INSPECTION/REINSPECTION(1.hr minimum) 1.00 PEDRAZA $ 95.00 <br /> Total for this Invoice $ 95.00 <br /> { Payment Due Date 9/20/2007 <br /> TOTAL DUE this Biking Period $ 95.00 <br /> 77 7 77 <br /> AUG 2 2007 _ N <br /> SI-ban <br /> I <br /> Please make Checks PAYABLE to: 'EHD' — Retunn a Copy of This STATEMENT with Your PAYMENT <br /> _ r f <br /> Pe es will be ded to bII Permit Fees For OES 1 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 D ' Date 46 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> k1_1_IP, l <br /> � J <br />