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CPG TO: .ICE OF REVENUE AND RECOVERY . <br /> ACCOUNT TRANSMITTAL PY <br /> ACCOUNTNO. DEPT.NO. REFERRAL <br /> 026000.0 1 DATE CO <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> SEI-SLABY ENVIRONMENTAL INC <br /> C/O NAME GUARANTOR SSN <br /> DEBBIE&ROBERT SLABY <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> SEI-SLABY ENVIRONMENTAL INC P.O. BOX 903 BORREGO SPRINGS CA 92004 760-767-0776 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 587 PALM CANYON DR BORREGO CA 92004 760-767-0776 <br /> USER REFERENCE NO. I BILLI STAI CYCLEI STATUS DATEI BMCI CBMCj INT IMONTHLY PAY AMT <br /> 13317 HAZMAT I I I I I I I I I I I I I I 1 1 1 1 1 112/15/07 <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 CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NONn <br /> 230 026000.0 2007 Hmmp Annual Fee $240.00 <br /> 3 Chems @ $15.00 Each $45.00 <br /> 10% Late Charge $28.50IN <br /> +1 1 1 1 <br /> TOTAL $313.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> SEI-SLABY ENVIRONMENTAL INC 760-767-0776 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 783 E ROTH RD FRENCH CAMP CA 95231 <br /> SP9HSE} CO-OWNER <br /> LAST FIRST MI TITLEJ SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> SEI-SLABY ENVIRONMENTAL INC 760-767-0776 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 783 E ROTH RD FRENCH CAMP CA 95231 <br /> PREPARED B I CHECKED B JDATE P' O �j Coy. 20 (3188 <br /> �� O O <br />