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SAN JOAQUIN COUNTY • <br />ENVIRONMENTAL HEALTH DEPART <br />304 E WEBER AVE - 3RD FLOOR <br />STOCKTON, CA 95202 <br />Phone: (209)468-3420 <br />INVOICE <br />BIER, WAYNE <br />TRIUMPHS ONLY <br /> <br /> <br />Health <br />Date prooram Description <br />Invoice # IN0160949 --- Date of Invoice : 3/26/2007 <br />3/26/2007 2220 <br />3126/2007 2399 <br />3/26/2007 9999 <br />i <br />Page 1 <br />COPY <br />Account ID AR0017158 <br />LMMOMMMOMMMA <br />FacilitylD FA0010158 <br />Date Printed 3/27/2007 <br />RE: TRIUMPHS ONLY <br />1881 E MARKET ST <br />STOCKTON, CA 95205 <br />OWNER: BIER, WAYNE <br />SM HW GEN <5 TONS/YR <br />UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />PAYMENT <br />Amount <br />11111111 IIIIII III VIII VIII VIII IIID VIII VIII VIII VIII IIII <br />$ <br />IIIIII VIII IIII IIII <br />206.00 <br />$ <br />24.00 <br />($ <br />206.00) <br />- Total for this Invoice $ 24.00 <br />Payment Due Date 4/25/2007 <br />TOTAL DUE this Billing Period $ 24.00 <br />PAYMENT <br />RECEIVED <br />A-Pir <br />2007 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br />For all SERVICE FEES <br />Penalties will b added to all Permit Fees For / Fees Penalties will be added at the Rate of 10% <br />after <br />Invoice <br />at the Rate off 100% of the Base Fee Penalties will badded <br />the Rate of 10% <br />30 Days after the Due Date 45 Days after the Invoice Date 60 Days ager the Invoice Date and each 30 Days thereafter <br />5254.rpt <br />