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JAN JUAUlJh4 GUUN I Y <br /> ENVIRONMENTAL HEALTH DEPARTMr"T Page 1 <br /> 304 E WEBER AVE . 3RD FLOOR <br /> PTO 95202 COPY <br /> Phone:e: (209(209)46 468-3420 <br /> INVOICE Account ID f AR0017429 <br /> Facility ID FA0010429 <br /> Date Printed F 2/28/2006 <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 /> Date Health <br /> Program Description Amount <br /> Invoice# IN0143033--Date of Invoice: 1/2712006 IIIIIIIIIIIVIIIVIIIVIIIVIIIIIIIIVIIIVIIVIIVIIIIII IIIIII VIIIIIIIIII <br /> 1/15/2006 9991 Credit Adjustment ($ 4.00) <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 285.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 505.00 <br /> Payment Due Date 311/$ <br /> SECOND <br /> EC N NOTICE TOTAL DUE this Billing Period $ 505.00 <br /> l NAil ). <br /> � 9 zooe <br /> SEEN VIq Q Ulr"'C'Ur.'I" <br /> ONM <br /> HEALTH DEP4WMEArr <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 1 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 /> 5254.rpt <br />