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SAN ,`OAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART T . Page 1 <br /> 304 E WEBER AVE -3RD FLOORSTOCKI- <br /> Phone: ON,209 46 95202 C � t ,f JAN 2 7 2095 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0016152 <br /> Facility ID F—FA-0 009152 <br /> LMMMMMMMMMOMMOM <br /> Date Printed 1/24/2005 <br /> ASSOCIATED TRACTOR SVC INC RE : ASSOCIATED TRACTOR SVC INC <br /> 1323 W CHARTER WAY 1323 W CHARTER WAY <br /> STOCKTON, CA 95206-1110 STOCKTON, CA 95206-1120 <br /> OWNER : TOM BENTZ <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0128973---Date of Invoice: 1/24/2005 II I I I I II VII VI IVII VIII V IIVIIIV I VI IVI 111111111111111111111111 <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 375.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total forthis Invoicel $ 599.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 599.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 3 2005 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <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 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 />