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014IY JVAUUIN L UUNI Y <br /> ENVIRONMENTAL HEALTH DEPARTMFKIT Page 1 <br /> 3u4 E WEBER AVE - 3RD FLOORSTOCK _ <br /> Phone: ON,209 46 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0016040 <br /> Facility ID FA0009040 <br /> Date Printed F 1/30/2006 <br /> lummmmmovmwmmommo <br /> BIG O TIRES #30 RE : BIG O TIRES #30 <br /> 302 N CHEROKEE LN 302 N CHEROKEE LN <br /> LODI, CA 95240 LODI, CA 95240 <br /> OWNER : DENNIS CUNNINGTON <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0142541 ---Date of invoice: 1/27/2006 III IIIIIIIIIIIIIII�IIVIIVIIVIIIIIIIIIIIIIIIIIIVIIIIIII1111111111111111111 <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 100.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 324.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 324.00 <br /> RFCF ✓�D <br /> SAN Fs -194 <br /> 20uo <br /> ENV, �uiN CofvuO <br /> IJ <br /> HFACT N DFPARtMF� <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 />