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r <br /> SAN JOAQUIN COUNTY Page 1 f <br /> ENVIRONMENTAL HEALTH DEPARTM y <br /> ` 304 E WEBER AVE -3RD FLOOR �._. <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICEAR0021209 <br /> AccnuntiD <br /> Facility ID FA0012722 <br /> Date Printed 11/19/2004 <br /> —11 <br /> COMMUNITY MEDICAL CENTER RE : LAWRENCE ELEMENTARY HEALTHY START <br /> LAWRENCE ELEMENTARY HEALTHY START 721 CALAVERAS ST { <br /> PO BOX 779 LODI, CA 95240 <br /> STOCKTON, CA 95201-0779 <br /> OWNER : COMMUNITY MEDICAL CENTERS INC <br /> Health <br /> Y—Date _or gym._ _Description Amount <br /> Invoice# IN0126612—Date of Invoice: 11/16/2004 Illlllll11111111111111IIIIIVIIIiIIIIIIIII11111III1111111IN111111111111111IN <br /> 11/16/2004 4557 MED WASTE LIMITED HAULER $ 70.00 <br /> Total for this Invoice $ 70.00 <br /> Payment Due Date 12/19/2004 <br /> TOTAL DUE this Billing Period $ 70.00 <br /> I <br /> i <br /> f <br /> I <br /> p4YMEINT <br /> RECEIVED <br /> DEL 17 2004 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> i <br /> i, <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 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 Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> k <br /> 5255.rpt <br />