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CPG # TO: -CE OF REVENUE AND RECOVERY . ACCOUNT TRANSMITTAL ACCOUNT NO. DEPT. NO. REFERRAL 026000.0 4/15/02 LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE STOCKTON TRANSPORT C/O NAME GUARANTOR SSN RICHARD WELSH MAILING STREET CITY ST ZIP CODE AREA PHONE NO. 4408 S HWY 99 STOCKTON CA 95215 209-946-0648 RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. 209-946-0648 USER REFERENCE NO. BILL STA CYCLE STATUS DATE BM CBI' C INT MONTHLY PAY AMT 4954 HAZMAT 1 1 1 1 1 1 1 1 12/31/01 CHARGES LAST -RECIPIENT -FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE SERVICE DATE: START STOP MED REC NO DATE OF CHARGE CHARGE DEPT. NO. DESCRIPTION AMOUNT CHARGE DEPT. NO. DESCRIPTION AMOUNT NO 230 026000.0 2001 Hmmp Annual Fee 2 Chems @ $15.00 Each $240.00 $30.00 Business Owners: Ic ar enee 10% Late Fee $27.00 PreviOusl Referred: 7/21/00, 5/14/99, 6/5/95, 6/17/94 & 3/17/94 - Revenue & 41355 TOTAL $297.00- GUARANTOR DOB DR LIC NO AUTO LIC NO PRIOR STREET CITY ST ZIP CODE EMPLOYER NAME EMPLOYER PHONE NO STOCKTON TRANSPORT REFRIGERATION 209-946-0646 EMPLOYER STREET CITY ST ZIP CODE 4408 S HWY 99 STOCKTON CA 95215 S E CO-OWNER LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO WELSH RENEE EMPLOYER NAME EMPLOYER PHONE NO STOCKTON TRANSPORT REFRIGERATION 209-946-0648 EMPLOYER STREET CITY ST.' ZIP CODE CA 1 95215 4408 S HWY 99 STOCKTON DATE PREPA D V � � C D Y 4/15/02 COL. 20 (3/68