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TO: OFFICE OF REVENUE & RECOVERY <br /> CPG: ACCOUNT TRANSMITTAL <br /> ACCOUNT NO DEPT NO REFERRAL DATE <br /> .23;L-A Z 042000 , /B 5 <br /> LAST- UARANTON <br /> - FIRST MI LAST A" FIRST MI <br /> Evans, Robert <br /> C/O NAME SSN/FED# DR.LIC.NO. <br /> Elon Inc 68-0246286 <br /> MAILING STREET CITY ST ZIP AREA PHONE# <br /> 891 Monticello Ln Manteca CA 95336 1(209)481-5180 <br /> FACILITY ADDRESS CITY ST <br /> 17333 S Comconex Rd Manteca CA 95336 (2091481-3442 <br /> USER REFERENCE NO <br /> Invoice#223858 <br /> COMMENTS: <br /> SERVICE DATE: <br /> START STOP <br /> 1/27/2012 1/27/2012 <br /> [BARGE CHARGE <br /> NO DEPT NO DESCRIPTION AMOUNT Ho DEPT NO DESCRIPTION AMOUNT <br /> Invoice #223858 <br /> 380 0420000 SM HW Gen Permit 213.00 <br /> AST Fac 10k-100k Gal 675.00 <br /> State Surcharge Fee 24.00 <br /> Electronic Rptg Surc 25.00 <br /> Permit Fee Penalty 213.00 <br /> Permit Fee Penalty 675.00 <br /> TOTAL 1,825.00 <br /> EMPLOYER NAME/SOURCE OF INCOME: EMPLOYER PHONE# <br /> EMPLOYER STREET CITY ST ZIP <br /> PREPARED BY: DATE: <br /> REVIEWED BY: DATE: /0 / <br />