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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM' T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-34 <br /> ccountlD AR0017971 <br /> Facility ID FA0010 771 <br /> LOMMEMMUMMMMA <br /> Date Printed 1/24/2005 <br /> ALEXANDER'S QUICK LUBE RE : ALEXANDER'S QUICK LUBE <br /> 808 S CHEROKEE LN 808 S CHEROKEE LN <br /> LODI, CA 95240 LODI, CA 95240 <br /> OWNER : LESLIE ALEXANDER <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0128412--Date of Invoice: 1/24/2005 111111111111111111111111 IN <br /> 124/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 130.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 364.00 <br /> Payment Due Date 2123/2005 <br /> TOTAL DUE this Billing Period $ 354.00 , <br /> PAYMENT <br /> RECEIVED <br /> JAN 3 12005 <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 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 /> 5255 rpt <br />