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SAN JOAQUIN COUNTY Page 1 <br /> ENV%0N?r1ENTAL HEALTH DEPART 'NT <br /> 304 E WEB.GR AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR00163 00 <br /> LUMEMEMMMMMME <br /> Facility ID FA000 33 0- <br /> Date Printed 3/27/2003 <br /> KUSTOM KURVES COLLISION REPAIR RE : KUSTOM KURVES BODY SHOP <br /> 4 N HOUSTON LN 4 N HOUSTON LN <br /> LODI, CA 95240 LODI, CA 95240-2420 <br /> OWNER : ROSE, DOUG <br /> Health <br /> Date orcgram Oescriptinn Amount <br /> Invoice# IN0103431 —Date of Invoice: 2/2712003 I 4-;!5.CID <br /> 2/27/2003 2220 SM HW GEN<5 TONS/YR $ -2.0 B <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 255.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Involce $ 472.50 <br /> Payment Due Date 3/29/2003 <br /> TOTAL DUE this Billing Period $ 'r47-72.5-07� <br /> PAYMENT <br /> S � �," ' y,' RECEIVED <br /> �e APR 3 2003 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENl1RONMGNTAI HFGLTH iA1S10N <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 />