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CPG # TO: OFFICE OF REVENUE AND RECOVERY <br /> ACCOUNT TRANSMITTAL COPY <br /> ACCOUNT NO. DEPT. NO. REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> ALL PRO PERFORMANCE <br /> C/O NAME GUARANTOR SSN <br /> RUBEN RUBALCAVA <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> ALL PRO PERFORMANCE 820 S CALIFORNIA ST A STOCKTON CA 95206 209-507-2799 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 1822 NIGHTINGALE AVE STOCKTON CA 95205 209-507-2799 <br /> USER REFERENCE NO. BILL TAT CYCLE STATUS DATE BM CBM INT MONTHLY PAY AMTr)l IF:noT PYMT RNA n <br /> ATF <br /> 14153 HAZMAT 3/20/10 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NOMARRATIVE <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT, NO. DESCRIPTION AMOUNT CHARGE DEPT. NO.1 DESCRIPTION AMOUNT <br /> Nn <br /> 230 026000.0 Addition Of 1 Chemical $15.00 <br /> Hazmat Penalty Fee $1.50 <br /> wo <br /> TOTAL $16.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> ALL PRO PERFORMANCE 209-507-2799 <br /> EMPLOYER STREET CITY I ST ZIP CODE <br /> 820 S AMERICAN ST STOCKTON CA 95206 <br /> SFGUS,& CO—OWNER <br /> ST FIRST MI TITLE SOC SEC NO. I DOB DR LIC NO AUTO LIC NO <br /> I I I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> ALL PRO PERFORMANCE 209-507-2799 <br /> EMPLOYER STREET CITY I ST T ZIP CODE <br /> 820S AMERICAN S STOC TCN CA 1 95206 <br /> REPARED BY CHECKED BY JDATE �� —�i�_/ COL. 20 (areal <br />