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SANJOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTIl'—VT Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0017945 <br /> Facility ID FA001094 <br /> LMOMMMMMMMEEM <br /> Date Printed 1/24/2005 <br /> TULEBURG AUTO BODY TOWING GARAGE RE : TULEBURG AUTO BODY TOWING GARAGE <br /> 1075 E BIANCHI RD 1075 E BIANCHI RD <br /> STOCKTON, CA 95210 STOCKTON, CA 95210 <br /> OWNER : BYRON PAIZS <br /> Date Health <br /> Program Description <br /> _ Amount <br /> Invoice# IND130340—Date of Invoice: 1/24/2005 1111111111111 pill 11111111 IN 1111111111111111111 <br /> 1/24/2005 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this lnvolce $/_ 224.00 <br /> Payment Due Date 2/231200j5-- <br /> TOTAL DUE this Billing Period $ 224.00 <br /> PAYMENT <br /> RECEIVED <br /> FEb 1 1 2005 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL i <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 For OES I 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 /> 5255.rpt <br />