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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMI Page t <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0022739 <br /> LMMMMEMMOMMEM <br /> Facility ID FFA0013605l <br /> loomommoommmomme <br /> Date Printed 2/24/2006 <br /> Immommommommmmmom <br /> TRACY DODGE CHRYSLER JEEP RE : TRACY DODGE CHRYSLER JEEP <br /> 3460 W NAGLEE RD 3460 NAGLEE RD <br /> TRACY, CA 95304 TRACY, CA 95376 <br /> OWNER : TRACY MOTOR CO <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0143268--Date of Invoice: 1/27/2006 IIIIIIIIIIIVIIVIIVIIIVIIVIIIIIIIIIIIIIVIIVIIIIIIIIIII VIIIIIIIIIII <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 315.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total forthis Invoice $ 539.00 <br /> Payment Due Date 31112006 <br /> TOTAL DUE this Billing Period $ 539.00 l <br /> ti <br /> �?a��'•�' r,rr <br /> t'!EqTH O,�r �f OUnij,, <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 />