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CPG'# TO: OFFICE OF REVENUE AND RECOVERY <br /> ACCOUNT TRANSMITTAL � O py <br /> ACCOUNT NO. DEPTN� REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> AVCO STEEL(MARIPOSA) <br /> C/O NAME GUARANTOR SSN <br /> AL VILLMAN <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> AVCO STEEL(MARIPOSA) 215 DAPHNE ST VALLEY SPRINGS CA 95252-8364 209-462-7977 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 1425 W CENTER ST MANTECA CA 95336 '209-462-7977 <br /> USER REFERENCE NO. BILL TAT CYCLE STATUS DATE BM GBM INT MONTHLY PAY AMT "PYM R B <br /> nATP <br /> 10433 HAZMAT 3/20/10 <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 DHARGE DEPT. NO. DESCRIPTION AMOUNT <br /> 230 026000.0 2010 Hazmat Fee $85.00 <br /> State Surcharge Fee $24.00 <br /> Electronic Surcharge $25.00 <br /> Hazmat Penalty Fee $8.50 <br /> TOTAL $142.50 <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 /> AVCO STEEL(MARIPOSA) 209-462-7977 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 7367 E MARIPOSA RD C STOCKTON CA 95215 <br /> 9VOU49 CO—OWNER <br /> ST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> I I I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> AVCO STEEL(MARIPOSA) 209-462-7977 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 7367 E MARIPOSA RD C STT ON CA 95215 <br /> PREPARED BY CHECKED BY ATE aZla�//V COL. <br />