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SAN JOAQUIN COUNTY <br /> Page 1 <br /> ENVIR0141 ERTAL HEALTH DEPARTMEI <br /> 304 E WEBER AVE -3RD FLOOR -" <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE A=unt ID AR0022665 <br /> Facility I FA0013576 <br /> Date Panted 10/2003 <br /> PREMIER SMOG &TUNE RE : PREMIER SMOG &TUNE <br /> 4532 MORADA PL 900 S CHEROKEE LN / <br /> STOCKTON, CA 95240 LODI, CA 95240 <br /> O ER : LAROZA, DINO S <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0104085--Date of Invoice: 2/2712003 <br /> 2/27/2003 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 100.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total Tor this Invoice $ 317.50 <br /> Payment Due Date 3/29/2003 <br /> f O TOTAL DUE this Billing Perlocil $ 317.50 <br /> PAYMENT <br /> RECEIVED <br /> MAR 2 6 2003 <br /> SAN JOAQUIN COUNTY <br /> fNURONMFN'v *SERVICES <br /> Nf;11 PNd VISr;y <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 all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10 <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5255.rpt <br />