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CPG # TO: �-FICE OF REVENUE AND RECOVERY <br /> 1.r ACCOUNT TRANSMITTAL '".100 PY <br /> ACCOUNT NO. DEPT. NO. REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> MACARTHUR TRANSMISSION <br /> C/O NAME GUARANTOR SSN <br /> MACORP INC <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 1011 MACARTHUR AVE TRACY CA 95376 209-836-1555 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 1011 MACARTHUR DR TRACY CA 95376 209-836-1555 <br /> USER REFERENCE NO. BILL TAT CYCLE STATUS DATE BMc1 CBM INT MONTHLY PAY AMT PYMT <br /> 10732 HAZMAT F3/15/09 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT. NO. DESCRIPTION AMOUNT HARGE DEPT. NO. DESCRIPTION AMOUNT <br /> NO <br /> 230 026000.0 2009 Hmmp Annual Fee $70.00 <br /> 2 Chems @ $15.00 Each $30.00 <br /> 10% Late Charge $10.00 <br /> State Service Fee $24.00 <br /> Sm Hz Gen<5 Tons/yr $213.00 <br /> Permit Fee Penalty $213.00 <br /> TOTAL $560.00 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> MACARTHUR TRANSMISSION 209-836-1555 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1011 MACARTHUR AVE TRACY CA 95376 <br /> SPQUSR� CO-OWNER <br /> ST FIRST MI TITLE SOC SEC NO. I DOB I DR LIC NO I AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> MACARTHUR TRANSMISSION 209-836-1555 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1011 MACARTHUR AVE TRACY CA 95376 <br /> PREPARED BY I I CHECKED BY ATE 6- � 0 9 COL. 20 (3 <br />