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III <br /> t & ° .: }a` '` i _ r '° "` "u, r3 rF <br /> b ' irk` x' 3 '� � 'FIFFFII f 114lN+;. 4ATTA Jin § r ,s3, t -> �. r LX t ^6`. +h k xF <br /> .x .. krx IF 14' + " `'A"'` k xe 7! �'"*s l rir <br /> r4"T's-`` - ' <br /> FF I <br /> Fk <br /> .r ' F . s v`t'r�a� s, .�, <br /> I IF TNDRIVRd a HIMr DEP" TMENT <br /> jil IFF Fir <br /> Part II Sources oCont ba��ansy��e h e�artme� M <br /> Tf <br /> IF 7WUcoberal o e e b r 0 � Id <br /> � <br /> 3 as aIF Ir,r ' eq p T <br /> ady'#.� `�5}'`i } .. .1 `^+'2 f y <br /> kk <br /> III mmmmmmmm I IF, k <br /> �W *� Y 11 <br /> ,.rr F,er, _ _ _? _ _ +' " ? "_ ,:. '� � ,Yt. .� ". .. ��,�` `/- . . . aT!'U9t Fan c ' <br /> �� =. f0 ► t10 .... ._..� . rt..� <br /> 3. FEDERAL FUNDS - State <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 0 150, 068 0 150,068 <br /> 015075 SUMMER FOOD PROGRAM INSPECTIONS 0 0 0 0 0 <br /> FEDERAL FUNDS TOTAL 1 , 172, 865 p <br /> 1 , 172, 865 p 15172, 865 <br /> 4. FEES ASSESSED BY STATE OR FEDERAL RULES - STATE <br /> 001020 TANNING FACILITIES 2,239 0 2,239 0 21239 <br /> 001020 BODY PIERCING 270 0 270 0 270 <br /> 001020 TATTOO PERMIT 45446 0 43446 0 4,446 <br /> 001020 MOBILE HOME AND PARKS 153318 0 15 ,318 0 15,318 <br /> 001020 FOOD HYGIENE PERMIT 16,339 0 165339 0 161339 <br /> 001020 BIOHAZARD WASTE PERMIT 165645 0 16,645 0 16,645 <br /> 001020 PRIVATE WATER CONSTR PERMIT 0 p <br /> 0 0 0 <br /> 001020 PUBLIC WATER ANNUAL OPER PERMIT 3 , 564 0 3 , 564 0 3 , 564 <br /> 001020 PUBLIC; WPTER CONSTR PERMIT 0 0 0 0 0 <br /> 001020 NON-SDWA SYSTEM PERMIT 0 0 0 0 0 <br /> 001020 SAFE DRINKING WATER 0 0 0 0 0 <br /> 001020 SWIMMING POOLS 543085 0 54,085 0 54,085 <br /> 001092 OSDS PERMIT FEE 210,618 0 210618 0 210,618 <br /> 001092 1 & M ZONED OPERATING PERMIT 0 0 0 0 0 <br /> 001092 AEROBIC OPERATING PERMIT 0 0 0 0 0 <br /> 001092 SEPTIC TANK SITE EVALUATION 0 0 0 0 0 <br /> 001092 NON SDWA LAB SAMPLE 0 0 0 0 0 <br /> 001092 OSDS VARIANCE FEE 0 p <br /> 0 0 0 <br /> 001092 ENVIRONMENTAL, HEALTH FEES 2, 575 p <br /> 25575 0 21575 <br /> 001092 OSDS REPAIR PERMIT 0 0 0 0 0 <br /> 001170 LAB FEE CHEMICALANALYSIS 0 0 0 0 0 <br /> 001170 WATER ANALYSIS-POTABLE 0 p <br /> 0 0 0 <br /> 001170 NONPOTABLE WATER ANALYSIS 0 0 0 0 0 <br /> 010304 MQA INSPECTION FEE 0 p <br /> 0 0 0 <br /> 001206 CENTRAL OFFICE SURCHARGE 319973 0 31 ,973 0 31 ,973 <br /> FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 35813072 0 358,072 0 3581l072 <br /> 5. OTHER CASH CONTRIBUTIONS - STATE <br /> 010304 STATIONARY POLLUTANT STORAGE TANKS 0 p <br /> 0 0 0 <br /> 090001 DRAW DOWN FROM PUBLIC HEALTH UNIT 49,686 0 495686 0 49,686 <br /> OTHER CASH CONTRIBUTIONS TOTAL 49,686 0 493686 0 495686 <br /> 6. MEDICAID - STATE/COUNTY <br /> 001056 MEDICAID PHARMACY 0 p <br /> 0 0 0 <br /> 001076 MEDICAID TB 0 p <br /> 0 0 0 <br /> 001078 MEDICAID ADMINISTRATION OF VACCINE 0 411l361 415361 0 415361 <br /> 001079 MEDICAID CASE MANAGEMENT 0 p <br /> 0 0 0 <br /> 001081 MEDICAID CHILD HEALTH CHECK UP 0 385 ,998 385,998 0 3857998 <br /> 001082 MEDICAID DENTAL 0 3905093 390,093 0 390,093 <br /> /ersion : 1 Page 3 of 7 <br />