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SANJOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART&T Page 1 <br /> x304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID I F AR00 773 99 <br /> Facility ID FA0 0-10-3 99 <br /> Date Printed 1/24/2005 <br /> IMEEMEMEMMENEEME <br /> WESTERN RADIATOR SVC OF LODI RE : WESTERN RADIATOR SVC OF LODI <br /> 1780 E ROOSEVELT ST 12 S CLUFF AVE <br /> STOCKTON, CA 95205 LODI, CA 95240 <br /> OWNER : TERALT INC <br /> Date Health Amount <br /> FiuyiaiT nee,-ri�bpn __..._ ._.___.. <br /> Invoice# IN0128295--Date of invoice: 1/24/2005 II II II II I V I VI I VII VI I VIII V I V II VII VIII IIII II VIII pli llp <br /> 1/24/2005 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 255.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 479.00 <br /> Payment Due Date 2/2312005 <br /> TOTAL DUE this Billing Period $ 479.00 <br /> a <br /> S <br /> RECEI VEE <br /> FEB 1 8 2005 <br /> SA NVIROUINCOUNTy <br /> HEALTH DERARTtijENT <br /> Please make Checks PAYABLE to: 'El — 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 /> 52i; pt <br />