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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> INVOIC COPY <br /> Account ID AR0022739 <br /> Facility ID FA0-0-13-6 0 <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 /> Data Health <br /> Program Description Amount <br /> Invoice# IN0236708---Date of Invoice: 2/1/2013 IIIIIIIVII VIIIVI VIIIIII VIVIVIIIIIIIII 1111111 <br /> 2/1/2013 1921 HMBP-Regular-Primary Location $ 345.00 <br /> 2/1/2013 2227 GEN 5<25 TONS PERMIT $ 1,672.00 <br /> 2/1/2013 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Invoice $ 2,052.00 <br /> �' a'� !7 y 11 13({ _6'°� Payment Due Date 3/3/2013 <br /> L,z a"mC� 'i.9 i9 Y iiii..rr 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 /> Penalties will be added to all Permit Fees For HMBP 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 />