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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM'-_ T Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0003775 <br /> Facility ID FA0004113 <br /> Date Printed 4/24/2009 <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# IN0183361 ---Date of Invoice: 1/5/2009 IIIIIIII IIIIII III IIIIIIIIII IIIII IIIII IIIII IIIIIIIIII IIIII IIII IIIIII IIIII IIIIIIII <br /> 1/5/2009 2755 EMPLOYEE HOUSING $ 155.00 <br /> 1/5/2009 9999 PAYMENT ($ 155.00) <br /> 4/14/2009 2765 EMPLOYEE HOUSING-PERMANENT>180 DAYS $ 60.00 <br /> OT10""E Total for this Invoice 1 $ 60.00 <br /> S E(C <br /> 4 Payment Due Date 5/24/2009 <br /> Invoice# IN0188931 ---Date of Invoice: 4/23/2009 I(IIIIII IIIIII III IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIIIII IIIII IIII IIII <br /> Hrs Employee <br /> 3/2/2009 2765 R28-OCCUPANCY RE-INSPECTION 1.00 RIVERA $ 105. <br /> Total for this Invoice $ 105.00 <br /> Payment Due Date <br /> TOTAL DUE this Billing Period $ 165.00 <br /> PPGE vE.a <br /> RE <br /> � 2pp9 <br /> MAC <br /> COUNT <br /> N 3OPQUtMEr11A�- <br /> SH \N 6EPPR�M�NT <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 />