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.awn4WMWV114 l Vu1VI T <br /> ENVIRONMENTAL HEALTH DEPARTMF"T Page 1 <br /> 304 E WEBER AVE-3RD FLOOR _ <br /> STOCKTON, CA 95202 � COPY <br /> Phone: (209)468-3420 <br /> INVOICE A=unt ID AR0022643 <br /> Facility ID F FA0013539 <br /> LUMMENIMMMMENOMIll <br /> Date Pnnted 1/30/2006 <br /> GEWEKE DODGE CHRYSLER RE : GEWEKE DODGE CHRYSLER <br /> PO BOX 1210 1255 S BECKMAN <br /> LODI, CA 95240 LODI, CA 95240 <br /> OWNER : GEWEKE DODGE CHRYSLER <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0143450—Date of Invoice: 1/27/2006 IIIIIIIIIIIIIIIIIIIIIIIIIIIVIII VIII VIII VIII VIII VIII VIII IIII IIIIIINil IIII IIII <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 375.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ <br /> Total forth is Invoice $ 599.00 <br /> Payment Due Date 6 <br /> TOTAL DUE this Billing Period $ 599.00 <br /> SANFE,B I � `^Ub� <br /> H ENV q'U/N COU <br /> FAGTH UFPMR � <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 />