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JAN JUAUUIN I:UUN I Y <br /> ENVIRONMENTAL HEALTH DEPARTM,7"T Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID I AR0003775 <br /> Facility ID FA0004113 <br /> Date Printed 5/27/2009 <br /> A SAMBADO & SON INC RE : A SAMBADO & SON 39-321 <br /> A SAMBADO & SON 39-321 14000 E EIGHT MILE RD <br /> 8077 N TULLY RD LINDEN, CA 95236 <br /> LINDEN, CA 95236 <br /> OWNER : SAMBADO, LAWRENCE J & BEVERLY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0191007---Date of Invoice: 5/26/2009 1MIT 11111111111111111111111111111111111111111111111111111IN11111111111ININ <br /> Hrs Employee <br /> 4/9/2009 2765 R28-OCCUPANCY RE-INSPECTION 1.00 RIVERA $ 105.00 <br /> 4/21/2009 2765 R28-OCCUPANCY RE-INSPECTION 0.80 RIVERA $ 84.00 <br /> Total for this Invoice $ 189.00 <br /> Payment Due Date 6/26/2009 <br /> TOTAL DUE this Billing Period $ 189.00 <br /> PAYI0E <br /> RECEIVED <br /> SUN 4 2009 <br /> SAN JOAQUIN <br /> ENVIFIONME OUN7y <br /> HEALTH DEPATAL <br /> RTMENT <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 /> 5254.rpt <br />