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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM"T <br /> / Page 1 <br /> 304 E WEBER AVE -3RD FLOOR .-.. � <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID FAR0016046 <br /> Facility ID FA0009046 <br /> Date Printed F 2/27/2003 <br /> CALIFORNIA RADIATOR WORKS RE : CALIFORNIA RADIATOR WORKS <br /> 328 S CALIFORNIA ST 328 S CALIFORNIA ST <br /> STOCKTON, CA 95203-3502 STOCKTON, CA 95203-3520 <br /> OWNER : FRANK BROCKMAN <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0103288—Date of Invoice: 2/2712003 <br /> 2/27/2003 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 285.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Invoice $ 502.50 <br /> Payment Due Date � 3/2912003 <br /> TOTAL DUE this Billing Period $ 502.500 <br /> 7 <br /> PAYMENT <br /> RECEIVED <br /> MAR 2 7 2003 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> i':FAI I6LDIV&0N-- <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 all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5255.rpt <br />