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SAN AAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0005683 <br /> Facility ID FA0005228 <br /> Date Printed 1/24/2005 <br /> MIGUEL A HERNANDEZ RE : MAIN BODY SHOP <br /> MAIN BODY SHOP 1861 E MAIN ST <br /> <br /> <br /> OWNER : HERNANDEZ, MIGUEL A <br /> Date Health <br /> Proaram Description Amount <br /> Invoice# IN0128441 ---Date of Invoice : 1/24/2005 IIIIII III III VIII VIII VIII VIII VIII VIII VIII VIII VIII III IIII VIII III III <br /> 1/24/2005 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 224.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 224.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 2 ZUL� <br /> SAN JOAOUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARI MtNT <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 OE5 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 /> 5255.rpt <br />