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SAN JOAQUIN COUNTY <br /> Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0017429 <br /> Facility ID F FA0010429 <br /> LMOMMOOMMOMONOM <br /> Date Printed 3/23/2005 <br /> LONNEENNOMENOMMS <br /> DOUBLE A TRUCK SVC RE : DOUBLE A TRUCK SVC <br /> PO BOX 7310 1675 W CHARTER WAY D <br /> STOCKTON, CA 95267 STOCKTON, CA 95206 <br /> OWNER : ANDREW SALMERON SR <br /> Health <br /> I Date pmnrgm Description Amount <br /> Invoice# IN0128311 —Date of Invoice: 1/24/2005 I III IIII III VIII VIII VIII VIII VIII VIII VIII VIII IIIII IIII IIIIII IIIII IIIIIIII <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 285.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> 3/15/2005 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> Total for this Invoice $ 537.50 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 537.50 <br /> rAYMENT <br /> ��°QQ <br /> RECEIVED <br /> DU <br /> �tti E96 MAR 3 1 2005 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> WE yyt0 iE0 APPRECIATE YOUR HEALTH DEPARTMENT <br /> PAYMENT TODAYI <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 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 />