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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTOWT • Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0017380 <br /> LWANNNEMMMNMN <br /> FacilityID FAO010380 <br /> LMMMmffmmmmmg <br /> Date Printed 5/9/2008 <br /> KEYSTONE AUTOMOTIVE INDUSTRIES INC RE : KEYSTONE AUTOMOTIVE INDUSTRIES INC <br /> <br /> STOCKTON, CA 95206 <br /> OWNER : KEYSTONE AUTOMOTIVE IND INC <br /> Date Health <br /> Prc3ram Description <br /> Amount <br /> Invoice# IN0175731 -••Date of Invoice: 5/9/2008 IIIIIIIIIIIIIIVIVIIIVIIIVIIVIIIIIIIIIIVIIIVIII IIIIIIIIIIIIIII IIII IIII <br /> 5/9/2008 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 5/9/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 237.00 <br /> Payment Due Date 6/8/2008 <br /> TOTAL DUE this Billing Period $ 237.00 <br /> Q <br /> N <br /> PP G��JE <br /> Mp�13 � GoNn <br /> SPN dOP ONMgtS�ECSC <br /> FS'IVtP OEpPR� <br /> N�yZN <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 OES/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 /> 5254.rpt <br />