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REWIVED Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME <br /> 600 E MAIN STREET MAR 1 <br /> STOCKTON, CA 95202 <br /> TY <br /> Phone: (209)468-3420 OFFICE OFEMERGENCYS R CEE <br /> INVOICE Account 11) AR0025009 <br /> Facility ID r FA0014702 <br /> LEMMMONEWONNONM <br /> Date Printed 1/28/2008 <br /> DIAZ,JORGE JR RE : COALCOMAN AUTO REPAIR <br /> COALCOMAN AUTO REPAIR 1042 S SINCLAIR AVE <br /> 1042 S SINCLAIR AVE STOCKTON, CA 95215 <br /> STOCKTON, CA 95215 <br /> OWNER : DIAZ,JORGE JR <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0171802--Date of invoice: 1/2512008 1111111111111III IIIII IIIII IIIII IIIII IIIIi 11111lllil1111111111111111111111111llil1111 <br /> 1/25/2008 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 100.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total torthis Invoice $ 337.00 <br /> Payment Due Date 2/2712008 <br /> TOTAL DUE this Billing Period $ 337.00 <br /> (�4 5t-. '-133 -7, c-D <br /> PWT <br /> E F-o <br /> MAR 13 2008 <br /> SAN JOAQUIN COUNTY <br /> -._- — - - @NVIRI7NmENTA6--.._- <br /> HEALTH DEPARTMENT <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 I 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 46 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br />