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IN N <br /> IN <br /> OWN <br /> �p �� IN <br /> Ix IN e IN <br /> yIN 4, NN <br /> rF INe <br /> s / <br /> ij h iell - A A A <br /> aI IN a AI O)( 1 � b11tr .1�ttl � ut tat 38rttBt i r re <br /> 5'. 14 <br /> s c <br /> Biber 1, 2813'to Septemb r .3l1I IN I IN , X14 <br /> State County Total CIS <br /> Timst Feud C6` ' Treat Fanid Other <br /> ( } Tn% i t Fund (cash) Contr butwk Total <br /> 3. FEDERAL FUNDS - State <br /> 007000 WIC ADMINISTRATION 4855339 0 485 ,339 0 485 ,339 <br /> 015009 MEDIPASS WAIVER-HLTHY STRT CLIENT SERVICES 0 0 0 0 0 <br /> 015009 MEDIPASS WAIVER-SOBRA 0 0 0 0 0 <br /> 007055 ARRA FEDERAL GRANT - SCHEDULE C 0 0 0 0 0 <br /> 015075 SCHOOL HEALTH TITLE XXI 1505068 0 1509068 0 1501068 <br /> 015075 SCHOOL HEALTH 0 0 0 0 0 <br /> 015075 SCHOOL HEALTH 0 0 0 0 0 <br /> 015075 SCHOOL HEALTH 0 0 0 0 0 <br /> FEDERAL FUNDS TOTAL 1 , 103 ,833 0 191035833 0 1 , 103 , 833 <br /> 4. FEES ASSESSED BY STATE OR FEDERAL RULES - STATE <br /> 001020 PUBLIC WATER ANNUAL OPER PERMIT 3 , 564 0 31564 0 31564 <br /> 001020 NON-SDWA SYSTEM PERMIT 0 0 0 0 0 <br /> 001020 SWIMMING POOLS 545085 0 545085 0 54,085 <br /> 001020 BODY PIERCING 270 0 270 0 270 <br /> 001020 MOBILE HOME AND PARKS 135414 0 13 ,414 0 139414 <br /> 001020 BIOHAZARD WASTE PERMIT 15 , 645 0 155645 0 159645 <br /> 001020 TANNING FACILITIES 2,242 0 29242 0 21242 <br /> 001020 MIGRANT HOUSING PERMIT 0 0 0 0 0 <br /> 001020 FOOD HYGIENE PERMIT 17 ,350 0 17,350 0 175350 <br /> 001020 TATTOO FACILITY SERVICES 1 ,643 0 19643 0 17643 <br /> 001020 PUBLIC WATER CONSTR PERMIT 0 0 0 0 0 <br /> 001020 SAFE DRINKING WATER 0 0 0 0 0 <br /> 001092 OSDS PERMIT FEE 222 ,777 0 2225777 0 2221777 <br /> 001092 AEROBIC OPERATING PERMIT 0 0 0 0 0 <br /> 001092 NON SDWA LAB SAMPLE 0 0 0 0 0 <br /> 001092 ENVIRONMENTAL HEALTH FEES 129988 0 12,988 0 12 ,988 <br /> 001092 I & M ZONED OPERATING PERMIT 0 0 0 0 0 <br /> 001092 SEPTIC TANK SITE EVALUATION 0 0 0 0 0 <br /> 001092 OSDS VARIANCE FEE 0 0 0 0 0 <br /> 001092 OSDS REPAIR PERMIT 0 0 0 0 0 <br /> 001170 LAB FEE CHEMICALANALYSIS 0 0 0 0 0 <br /> 001170 NONPOTABLE WATER ANALYSIS 0 0 0 0 0 <br /> 001170 WATER ANALYSIS=POTABLE 0 0 0 0 0 <br /> 010304 MQA INSPECTION FEE 0 0 0 0 0 <br /> 001206 CENTRAL OFFICE SURCHARGE 33 ,344 0 335344 0 335344 <br /> 001093 CHD ON-LINE BILLING FEE 0 0 0 0 0 <br /> FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 377,322 0 377,322 0 3773322 <br /> 5. OTHER CASH CONTRIBUTIONS - STATE <br /> 010304 STATIONARY POLLUTANT STORAGE TANKS 0 0 0 0 0 <br /> 090001 DRAW DOWN FROM PUBLIC HEALTH UNIT 336,253 0 336,253 0 3365253 <br /> 031005 CHDTF CASH TRANSFER 0 0 0 0 0 <br /> OTHER CASH CONTRIBUTIONS TOTAL 336,253 0 3365253 0 336,253 <br /> 6. MEDICAID - STATE/COUNTY <br /> 001056 MEDICAID PHARMACY 0 0 0 0 0 <br /> Version : 2 Page 3 of 7 <br />