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CPG # TO: - IFICE OF REVENUE AND RECOVERY <br /> ACCOUNT TRANSMITTAL <br /> ACCOUNT NO. DEPT.NO. REFERRAL <br /> 026000.0 1 8/8/03 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> EAST BAY MUNICIPAL UTILITY DIST- <br /> C/O NAME GUARANTOR SSN <br /> EAST BAY MUNICIPAL UTILITY DIST <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> EAST BAY MUNICIPAL UTILITY DIST-CAMANCHE POWERHOUSE P.O.BOX 24055, MS 704 OAKLAND CA 209-946-8043 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> EBMUD REGULATORY COMPLIANCE OFFICE MS704, OAKLAND CA 94623-1055 510-287-1086 <br /> USER REFERENCE NO. BILL STAJ CYCLE STATUS DATE BMI CBMC INT MONTHLY PAY AMT <br /> 8942 HAZMAT 6/15/03 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USERREFERENCE NO/NARRATIVE <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 2003 Hmmp Annual Fee $240.00 <br /> 7 Chems @ $15.00 Each $105.00 <br /> 10% Late Charge $34.50 <br /> TOTAL $379.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> EAST BAY MUNICIPAL UTILITY DIST-CAMANCHE 209-946-8043 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 23900 E BUENA VISTA RD CLEMENTS CA 95227 <br /> 9£AH9E` CO—OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> EAST BAY MUNICIPAL UTILITY DIST-CAMANCHE POWERHOUSE 209-946-8043 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 23900 E BUENA VISTA RD CLEMENTS I CA 1 95227 <br /> PREPARED BY £_;:Y CHECKED B DATE 88/03 coc. zo lyse <br />