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ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 — —' <br /> Phone: 1209) 468-3420 <br /> INVOICE Account 10 AR0017945 <br /> Facility ID FA0010945 <br /> Date Punted F 4/26/2004 <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 /> ti <br /> Program Description Amount <br /> Invoice# IN0116118---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN 45 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 285.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> 3/21/2004 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> 4/15/2004 9994 PERMIT FEE PENALTY $ 200.00 <br /> Total for this Invoice $ 737.50 <br /> Payment Due Date 3/6/2004 <br /> RASTD F TOTAL DUE this Billing Period $ 737.50 <br /> VILE WOULD ;t°APPF,ECi +T.E YOUR --- - <br /> PAYMENT TODAY! <br /> PAYMENT <br /> RECEIVED <br /> 0N APR $ 0 2ooa <br /> YnUrl 1-1--AIlffH s�ERMIT FOH <br /> -f 1-4,E C U!+ '`IT YEAR SAN JOAQUIN COUNTY <br /> WILL NOT B- `;JED UNTIL ENVIRONMENTAL <br /> PAST DUE- :``o:)UNTS HEALTH DEPARTMENT <br /> ARE PAID uv FULL <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 /> 5255.rpt <br />