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vnn UVMWuI1Y t.VUNI T <br /> ENVIRONMENTAL HEALTH DEPARTME"T Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE � 1�„�� Account D AR0020223 <br /> Facility ID FA0012369 <br /> Date Printed F 5/28/2008 <br /> GREG & SUSAN LOOMIS RE : BRICKYARD AUTOMOTIVE <br /> BRICKYARD AUTOMOTIVE 820 S BECKMAN RD STE 3B <br /> 820 S BECKMAN RD STE#313 LODI, CA 95240 <br /> LODI, CA 95240 <br /> OWNER : LOOMIS, GREG & SUSAN <br /> Date Health <br /> Program Description Amount <br /> invoice# IN0171607—Date of Invoice: 1/25/2008 IIIIIIIIIIIIIIVIIIVIIII'IVIIIIIIII I'll VIIIIIIIII��IIIIIIIIIII VIII1IIIII'I <br /> 1/25/2008 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 285.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2008 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> 4/15/2008 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this Invoice $ 763.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 763.50 <br /> DUE <br /> Delinquent charges <br /> ^avid be iorWarded to <br /> COLLECTIONS, <br /> in 30 days. <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> [P��a2t <br /> lties will be added to all Permit Fees For OES I HMMP Fees For all SERVICE FEES <br /> 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 />