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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMr' 'T 9 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE A=unt ID AR0031898 <br /> Facility ID FA0018129 <br /> Date Printed F 2/22/2007 <br /> Imommmmmommma <br /> CARRILLO-GAMSOA, CLEMENTE RE : CHARTER WAY APPLIANCE <br /> CHARTER WAY APPLIANCE 920 E CHARTER WAY <br /> 2300 E WATERLOO RD#3 STOCKTON, CA 95206 <br /> STOCKTON, CA 95205 <br /> OWNER : CARRILLO-GAMSOA, CLEMENTE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0159627---Date of Invoice: 1/25/2007 11111111111111111111 IN 1111111111111111111 <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 230.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 230.00 <br /> pS� <br /> F RFCF�OT <br /> Fg 2 <br /> Sq (,j Z 2407 <br /> H R/y1'/g0 U/NC <br /> �lI-, <br /> jPAS CO <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 /> 5254.rpt <br />