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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMr 'T Page 1 <br /> 600E MAIN STREET <br /> STOCKTON, CA 95202 l�l✓J7 U <br /> Phone: (209)468-3420 <br /> Am <br /> 10 <br /> INVOICE Account lD <br /> Facility ID <br /> Date Printed 3/24/2010 <br /> Imawmwmmmmmmmnm <br /> REHAN ANWAR RE : VALLEY SMOG & REPAIR <br /> VALLEY SMOG & REPAIR 325 E KETTLEMAN LN <br /> 325 E KETTLEMAN LN LODI, CA 95240 <br /> LODI. CA 95240 <br /> OWNER : ANWAR, RERAN/ KHAN, KASHIF <br /> Date Health <br /> Program Description Amount <br /> -2Z I je=j <br /> Invoice# .—Date of Invoice: 3/24/2010 I IIIIIII VIII III VIII VIII VIII VIII VIII VIII VIII VIII IIID IIII IIIIII VIII IIII IIII <br /> 3/24/2010 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 3/24/2010 2244 2010 HAZMAT FEE $ 100.00 <br /> 3/24/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/24/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> Total for this Invoice $ 362.00 <br /> Payment Due Date 4/23/2010 <br /> TOTAL DUE this Billing Period $ 362. 0 <br /> �JAu� Illll � . <br /> PAYMENT <br /> � � RECEIVED <br /> �K (� a MAR 2 2 2010 <br /> SAN JOI QUIN COUNTY <br /> ENV�1 u AL <br /> HEALTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> l <br /> Penalties will be added to all Permit Fees For DES I 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 />