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f �irtii�r.,vnvtu,ry Page 1 <br /> ENVIRQNMENTAL HEALTH DEPARTMF"Y <br /> 600 E MAIN STREET RECEIVED <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 APR 2 0 2009 <br /> INVOI,C� 'SAN JOAQUIN COUNTY Account ID AR0033302 <br /> FFICE OF EMERGENCY SERVICES <br /> Facility ID FA001$757 <br /> Date Printed 3/25/2009 <br /> MOONLIGHT AUTO RE : MOONLIGHT AUTO <br /> 2560 S EL DORADO ST 2560 S EL DORADO ST <br /> STOCKTON, CA 95206 . STOCKTON, CA 95206 <br /> OWNER : 'JOSE ROMERO <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0187081 --Date of Invoice: 1/29/2009 flllllllliiillllillilllillllllilll1111111llllllfillllllllfilillllllllilillllllllf Illi <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 85.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2009 9987 Haz Mat Program Penalty Fee $ 8.50 <br /> 'total for this Envoice $ 117.50 <br /> Payment Due Date 2/28/2009 <br /> TOTAL DUE this Billing Period $ 117.50 <br /> Delinquent charges. <br /> will be forwarded to <br /> COLLECTIONS <br /> lr 30 dav3. <br /> Please make Checks PAYABLE to: 'EHD' Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For OES I HMMP Fees For all SERVICE FEES <br /> at 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 theinvoice Date and each 30 Days thereafter <br /> 5254irpt' <br />