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4QUIN COUNTY <br />AMENTAL HEALTH DEPARTV 'VT <br />VEBER AVE - 3RD FLOOR — <br />:KTON, CA 95202 <br />le: (209) 468-3420 <br />INVOICE <br />SALAZAR'S QUALITY TRUCK WORKS <br />4720 CAYMAN CT <br />STOCKTON, CA 95210 <br />Date Health <br />Proaram Description <br />Invoice # IND130276 -- Date of Invoice : 112412005 <br />Page 1 <br />Account ID AR0026869 <br />LMEMMWSMEMEMA <br />Facility ID F FA0015569 <br />Date Printed F 4/22/2005 <br />RE: SALAZARS QUALITY TRUCK WORKS <br />1622 E ALPINE AVE <br />STOCKTON, CA 95205-2525 <br />OWNER: SALAZARS QUALITY TRUCK WORKS <br />1/24/2005 <br />2244 <br />2005 HAZMAT FEE PLUS 5 YEARS BACK BILLING <br />112.4/2005 <br />2399 <br />UNIFIED PROGRAM FAC STATE SERVICE FEE <br />2/15/2005 <br />9997 <br />CORRECTION TO A CHARGE <br />2/25/2005 <br />9999 <br />PAYMENT <br />3/22/2005 <br />9999 <br />PAYMENT <br />4/20/2005 <br />9999 <br />PAYMENT <br />Invoice # IND131806 --- Date of Invoice : 4/4/2005 <br />4/4/2005 2220 SM HW GEN <5 TONS/YR <br />S l i <br />Amount <br />I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br />g 1,530.00 <br />$ 24.00 <br />($ 510.00) <br />is 261.00) <br />$ 261.00) <br />$ 261.00) <br />Total for this Invoice $ 261.00 <br />Payment Due Date 2- <br />I IIIIIII IIIIII III VIII (IIII (IIII (IIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br />$ 200.00 <br />Total for this Invoice 200.00 <br />Payment Due Date 141 <br />TOTAL DUE this Billing Period $ 461.00 <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 thereafter <br />5 rpt <br />