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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPART' IT <br />304 E WEBER AVE - 3RD FLOOR <br />STOCKTON, CA 95202 <br />Phone: (209) 468-3420 <br />INVOICE <br />DICK GUTHRIE <br />J & D AUTO BODY INC <br />1011 S CHEROKEE LN <br />LODI, CA 95240-4305 <br />Page 1 <br />Account ID <br />AR0021499 <br />Fadlity ID <br />FA0012811 <br />Date Pnnted <br />2/9/2006 <br />RE: J & D AUTO BODY INC <br />400 N CLUFF AVE A <br />LODI, CA 95240 <br />OWNER: GUTHRIE, DICK A <br />Date Health <br />Program Description Amount <br />Invoice # IN0143231 — Date of Invoice : 1127/2006 <br />1/27/2006 2220 SM HW GEN <5 TONSNR <br />1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />IImiiiAllllhlIIAIIIIAniIIASIIIAIIIAIAAmmnmmIAI <br />$ 200.00 <br />$ 24.00 <br />Total for cols Invoice $ 224.00 <br />Payment Due Date 3/1/2006 <br />TOTAL DUE this Billing Period S 224.00 <br />AIAR <br />S "JOAQUW. CC(7A,n <br />H6gtrHp M NT <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 thereafte <br />i2s4 cot <br />