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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM�T <br /> 304 E,WEBM'R AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0025455 <br /> Facility ID FA0014919 <br /> Date Printed 2/5/2004 <br /> FELIX JACOBS RE : JAUREGUI BODY SHOP <br /> JAUREGUI BODY SHOP 819 E FREMONT ST <br /> 819 E FREMONT ST STOCKTON, CA 95202 <br /> STOCKTON, CA 95202 <br /> OWNER : JACOBS, FELIX <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0117578---Date of invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 224.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 224.00 <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 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 /> 5255.rpt <br />