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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME <br /> 600 E MAIN STREET c tn `w1i <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE =° �� � Account ID AR0016876 <br /> LMMMMMENMENMA <br /> Facility ID FA0009876 <br /> Date Printed F1/28/2008 <br /> LMNENMEEMMUMMM <br /> DEJONG, BLAINE RE : BLAINE DEJONG'S AUTO WORKS INC <br /> BLAINE DEJONG'S AUTO WORKS INC 324 N CLUFF AVE <br /> 324 N CLUFF AVE LODI, CA 95240 <br /> LODI, CA 95240 <br /> OWNER : BLAINE DEJONG'S AUTO WORKS INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0170350•—Date of Invoice: 1125/2008 IIIIIIIIIIIVIIVIIVIIIVIIIVIIIVIIIVIIIVIIIVIIIIIIIIIIIIIIIIIIIIIIIII <br /> 1/25/2008 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 115.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 352.00 <br /> Payment Due Date 2/2712008 <br /> TOTAL DUE this Billing Period $ 52.00 <br /> N <br /> C J�PQU,N CO <br /> ��TH DEPP�� <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 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 /> 5254.rpt <br />