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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME0 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD F AR0025455 <br /> LUMOMMMMEMMMM <br /> Facility ID FA0014919 <br /> Date Printed 9/12/2003 <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 <br /> Program Description Amount <br /> Invoice# IN0111044---Date of Invoice: 9/12/2003 <br /> 9/12/2003 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 9/12/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Invoice $ 217.50 <br /> Payment Due Date 10/12/2003 <br /> TOTAL DUE this Billing Period $ 217.50 <br /> T <br /> ECE VED <br /> OCT 9p, N�>V <br /> Sp08L1�HE QHS 0HO s oh <br /> IROHMENtAL HEAL <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 /> 5255Flit <br />