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.enr.,evnvr�o. ,.vvi. Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMF6 . <br /> 600 E MAIN STREET <br /> STOCKTON, .CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE g � a� <br /> Account ID AR0017776 <br /> Facility ID FA0010776 <br /> Date Printed F 4/28/2010 <br /> J&M TRANSMISSION INC RE : J&M TRANSMISSION INC <br /> 7944 W 11TH ST#F 7944 W 11TH ST F <br /> TRACY, CA 95304 TRACY, CA 95304-9303 <br /> OWNER : MAURICIO URTEAGA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0198132---Date of Invoice : 2/2/2010 /III II I I II V I VI I V I VIII V II I II II II V I /III VIII/VIII/III/III <br /> 2/1/2010 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 85.00 <br /> 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/20/2010 9987 Haz Mat Program Penalty Fee $ 8.50 <br /> 4/15/2010 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total forthis Invoicel $ 568.50 <br /> Payment Due Date 3/412010 <br /> ( 6 TOTAL DUE this Billing Period $ 568.50 <br /> Delinquent c;!7vr(-TDs <br /> will be l'or vaucled ie <br /> ALL'€,1`;°tit::,:;;'S <br /> Ale. , in 30 daa�- <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 DES 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 the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />