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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM , ( Page 1 <br /> 600 E MAIN STREET _ 190 <br /> - <br /> STOCKTON, CA 95202 •y, <br /> Phone: (209)466-5420 � lJ <br /> INVOICE � �� RECE'VE® A=uM ID' AR0031479 <br /> N O V 2 9 2010 fsctlb l0 FA001 7936 <br /> SAN JOAQUIN COjJNTY nae P,;nted 11IW2010 <br /> OFFICE OF EMERGENCY SERVICES <br /> US TRUCK TRAILER REPAIR RE c US TRUCK TRAILER REPAIR <br /> 3833 DUCK CREEK OR 3633 DUCK CREEK DR <br /> STOCKTON,CA 95216 STOCKTON,CA 95215 <br /> OWNER: QAMAR HUSSAIN <br /> Dale Health <br /> Pram Description Amount <br /> InvOleeri tNO2oraast--Date ofltwolca: 91z3,2u,o IN IIN1gn111111111Hill <br /> 91231201D 2244 2010 HAZMAT FEE PLUS 1 YEAR BACK HUNG S 570.00 <br /> 14/15/2010 8997. Haz Mat Program Penalty Fee i 57.00 <br /> TOM ftr this b..0 627.00 <br /> Payment Due Date 10!x41209 0 <br /> TOTAL DUE this stmng Period 627.00 <br /> R R, ST DUB, <br /> #DL��Eir,quent chargee, <br /> in 20—days- . <br /> Please make Checks PAYABLE to: 'EHcr Retum a Copy of This STATEME=NT with Your PAYMENT <br /> PonnitJes VAII be added m all Penh Fess For OES 1 HMMP Fees For•p SERVICE FEES <br /> at the hale of 100%of the One Fee ftminea wmi to added at the Rats of 10% Pwm ties will be added at the Rate Of 10% <br /> 30 Z"aftar the Out Gate 45 Days after the InyolCa Cats a0 drys aRer the Invoice Otto and each 30 Dans thereafts <br />