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CPGk TO: 'ICE OF REVENUE AND RECOVERY Copy <br /> ►� ACCOUNT TRANSMITTAL `"'� <br /> ACCOUNT NO. DEPT.NO. DATE REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> WEST COAST AGGREGATES INC <br /> C/O NAME I GUARANTOR SSN <br /> RICHARD DE ATLEY <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> WEST COAST AGGREGATES INC (408)354-7904 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 37350 S BIRD RD TRACY CA 95304 (925)371-0260 <br /> USER REFERENCE NO. BILL STAA CYCLE STATUS DATEI BM CBMCJ INT MONTHLY PAY AMT <br /> 9557 HAZMAT 2/23/05 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NOMARRATIVE <br /> DOR <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NO <br /> 230 026000.0 2005 Hmmp Annual Fee $240.00 <br /> 3 Chems CEJ $15.00 Each $45.00 <br /> 10% Late Charge $28.50 <br /> State Service Fee $24.00 <br /> c: <br /> TOTAL $337.50 <br /> GUARANTOR <br /> DOB DR LIC NO---F AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> WEST COAST AGGREGATES INC (408)354-7904 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 37350 S BIRD RD TRACY CA 1 95304 <br /> SP19693 CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> WEST COAST AGGREGATES INC (408)354-7904 <br /> EMPLOYER STREET CITY ST ZIPCODE <br /> 37350 S BIRD RD TRACY CA 95304 <br /> PREPARED BY CHECKED BY DATE II -y o S cOL. 20 urea <br />