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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMVT Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0025455 <br /> FacilitylD FA0014919 <br /> Date Printed 1/30/2006 <br /> FELIX JACOBS RE : JAUREGUI BODY SHOP <br /> JAUREGUI BODY SHOP 819 E FREMONT ST <br /> 43 CONNIE CT STOCKTON, CA 95202 <br /> BAY POINT, CA 94565-1576 <br /> OWNER : JACOBS, FELIX <br /> Date Health <br /> Program Description Amount <br /> Invoice# IND144481 ---Date of Invoice: 1/27/2006 I III IIII I IIIVIIIVIIIVI VII VII VIII VIIIIIIIIIIII IIIIIIII IIIIIIIIIIIII <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 224.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 224.00 <br /> PAYMEN <br /> RECEIVED <br /> MAR 14 2006 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <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 I 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.rp1 <br />