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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM�,aT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Amount ID AR0016876 <br /> Facility ID FA0009876 <br /> Date Printed 1/31/2011 <br /> LNMENEENOMMMMIll <br /> ZULIM,JOHN; SARSTED, PAUL RE : J P AUTOWORKS &SMOG <br /> 324 N CLUFF AVE 324 N CLUFF AVE <br /> LODI, CA 95240 LODI, CA 95240 <br /> OWNER : ZULIM,JOHN; SARSTED, PAUL <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN02109"---Date of Invoice: 1/3112011 <br /> IIIIIII IIIIII IIIIIIII IIIIIIIIIIIIIIIVIII IIIIIIIIII VIIIIIIIIIIIIIIIIIIVIIIIIIIIIII <br /> 1/28/2011 2220 SM HW GEN<5 TONSNR $ 21300 <br /> 1/28/2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/28/2011 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> Total for fhis Invoice $ 262.00 <br /> Payment Due Date 3/2/2011 <br /> TOTAL DUE this Billing Period $ 262.00 <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 OES/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 />