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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTI IT <br /> 600 E MAIN STREET COPY <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AMINIMM 24 <br /> Facility ID FA0009124 <br /> Date Printed 1/28/2008 <br /> IMMEMMMONEMOMS <br /> GEWEKE FORD MERCURY JEEP EAGLE RE : GEWEKE FORD MERCURY JEEP EAGLE <br /> PO BOX 1210 1045 S CHEROKEE LN <br /> LODI, CA 95241 LODI, CA 95240 <br /> OWNER : GEWEKE, DARYL <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0170079--Date of Invoice: 1/25/2008 ll11lll1111111111111111111111111pill Hill IMI1119111111111111I1111u1111m1111u1111 <br /> 1/25/2008 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 390.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total forth;,Inwic,11 $ 627.00 <br /> Payment Due Date 2/27/2008 <br /> TOTAL DUE this Billing Period $ 27. <br /> PAYMENT <br /> RFCEIVFn <br /> FEB 7 2008 <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 OES/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 aker the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />