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SAN JOAQUIN COUNTY • Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM* <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468.3420 <br /> INVOICE AccountlD LMENOMMMMMMI <br /> AR0017389 <br /> FacilitylD F FA00 003 9— <br /> LMMMMMXMMMMA <br /> Date Printed2/5/2004 <br /> LMEMEMOMMOMMMM <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 /> Health A:.ount <br /> Dane Program Description <br /> Invoice# IN0116001 ---Date of Invoice : 2/412004 $ 2C0.00 <br /> 2/4/2004 2220 SM HW GEN <5 TONS/YR $ 255.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 21..00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE <br /> Total for this Invoice $ 479.00 <br /> Payment Due Date 3' <br /> TOTAL DUE this Billing Period $ 479.00 <br /> PAYME`S '_ <br /> RECENED <br /> MAR 3 fru <br /> SAN JOAQUIN COUN I y <br /> ENVIRONME61Tt L <br /> HEALTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> For all SERVICE FEES <br /> Penalties will be added to all Permit Fees For DES I HMMP Fees penalties will be added at the Rate of 10 <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 45 Days after the Invoice Date 60 Days after the Invoice Dat,aneach30Days thereafter <br /> 5255.rpt <br />