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... ....... ............ ... . <br /> 5AN JUAQUIN UUUN I T Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTML, <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> INVOICE Copy � Account ID AR0016138 <br /> Facility ID FA0009138 <br /> Date Printed 5/30/2012 <br /> MANTECA AUTO PLAZA RE : MANTECA AUTO PLAZA <br /> PO BOX 1286 1190 S MAIN ST <br /> MANTECA, CA 95336 MANTECA, CA 95336 <br /> OWNER : MANTECA AUTO PLAZA <br /> Date Health <br /> Program Description Amount <br /> Invoice IN0223190—Date of Invoice:,1/3012012 IIIIIIIIIIIIIIIIIVIIIVIIIIIIIIIIIIIVIIIIIIIIIIIIIIIIII VIII IIIIIIIIIIVIIIIIIIIIII <br /> 1/27/2012 2220 SM HW GEN<5 TONS/YR $ 213.00 - <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 360.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 112712012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/15/2012 9987 Haz Mat Program Penalty Fee $ 36.00 <br /> 4/15/2012 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for thls Invoice $ 871.00 <br /> PAST DUE <br /> TOTAL DUE this;--Billing od $ 871.00 <br /> PAT ®UE <br /> Delinquent charges <br /> Will be forwarded to <br /> COLLECTIONS <br /> in 30 days. <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/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 />