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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-34 <br /> ccuntID AR0017971 <br /> Facility ID FA0010971 <br /> Date Printed 4/2612004 <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# IN0116123---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE S 130.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE S 24.00 <br /> 3/21/2004 9987 Haz Mat Program Penalty Fee S 13.00 <br /> 4/15/2004 9994 PERMIT FEE PENALTY S 200.00 <br /> Total for this Invoice $ 567.00 <br /> Payment Due Dale 3LEL2004 <br /> TOTAL DUE this Billing Period $ 567.00 <br /> 9 <br /> d`"s I � %� SD�I{4ti/ PAYMEN <br /> WE WOULD 1',PEe-E.C1ATEYOUR RECEIVED <br /> QAYMIZENTTODAY. 417P JUN 15 2004 <br /> � <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> �TTC'f_Pt <br /> YdUt1 I1E,117H -D RMIT FOR <br /> THE CURT;ENT YEAR <br /> VJILLNOT DC l SUED UNTIL <br /> PAST DUE AMOUNTS <br /> ARE PAID IN FULL <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 />