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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0022739 <br /> Facility lD FA00-13-6 0-5 <br /> Date Printed 2/28/2013 <br /> MUELLER, MARIA RE : TRACY CHRYSLER JEEP DODGE <br /> TRACY CHRYSLER JEEP DODGE 3460 NAGLEE RD <br /> 3460 NAGLEE RD TRACY, CA 95304 <br /> TRACY, CA 95304 <br /> OWNER : SKIBBEREEN INC <br /> Date Hcalth <br /> Program Description <br /> Amount <br /> Invoice# IN0236708---Data of invoice: 2/1/2013 IIIIIIII IIIIIIIIIIIII VIII VIIIIIIIIIIIIIIiIII IIIIIIIIIIIIIIIII IIIIIIIIII VIII IIII IIII <br /> 2/1/2013 1921 HMBP-Regular-Primary Location <br /> 2/1/2013 2227 GEN 5<25 TONS PERMIT $ 345.00 <br /> 2/1/2013 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 1,672.00 <br /> $ 35.00 <br /> Total for this Invoice $ 2,052.00 <br /> Payment Due Date 3/3/2013 <br /> TOTAL DUE this Billing Period $ 2,052.00 <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Pena7the <br /> s will be added to all Permit Fees For HMBP Fees For all SERVICE FEES <br /> at Rate of 100%of the Base Fee Penalties will be added at the Rate of to-/. Penalties will be added at the Rate of 10 <br /> 0 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 />