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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTM--'T <br />600 E MAIN STREET <br />STOCKTON, CA 95202 <br />Phone: (209) 468-3420 <br />INVOICE <br />SALAZARS QUALITY TRUCK WORKS <br />PO BOX 8236 <br />STOCKTON, CA 95208-0236 <br />• �, _ Page 1 <br />4A=unt <br />0-V <br />ID AR0026869 <br />Facility ID FA0015569 <br />Date Printed 2/26/2010 <br />AJV �J <br />{ RE : SALAZARS QUALITY TRUCK WORKS <br />` �rJ 1&24 E ALPINE AVE <br />STOCKTON, CA 95205-2525 <br />Se ER`'�: SALAZARS QUALITY TRUCK WORKS <br />d <br />Date Health I <br />Program Description Amount j <br />Invoice # IN0199476 -- Date of Invoice: 212/2010 <br />2/1/2010 2220 SM HW GEN <5 TONS/YR <br />2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE <br />I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111111IIIIIIIIIIIIII111111fill 119111 <br />$ 213.00 <br />$ 24.00 <br />$ 25.00 <br />Total for Nis Invoicel $ 262.00 <br />Payment Due Date 3/4/2010 <br />TOTAL DUE this Billing Period $ 62.00 <br />h. <br />AEC;EIVL-U <br />MAR 2 4 2010 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL <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 <br />For OES / HMMP Fees <br />For all SERVICE FEES <br />at the Rate of 100% of the Base Fee <br />Penalties will be added at the Rate of 10% <br />Penalties will be added at the Rate of 10% <br />30 Days after the Due Date <br />45 Days after the Invoice Date <br />60 Days after the Invoice Date and each 30 Days thereafter <br />5254.rpt <br />