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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMF"T Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0005863 <br /> Facility ID FA0005396 <br /> LUMMMOMMUMMEM <br /> Date Printed 1/28/2008 <br /> BRUCE & JACK AUTOMOTIVE RE : BRUCE & JACK AUTOMOTIVE <br /> <br /> STOCKTON, CA 95202 <br /> OWNER : LA BERGE, JACK <br /> Date Health <br /> Program Description <br /> Am90nt <br /> Invoice# IN0170027—Date of Invoice : 1/25/2008 111111111 IN <br /> 1/25/2008 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 130.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 2400 <br /> Total for this Invoice $ 367.00 <br /> Payment Due Date 2/27/2008 <br /> TOTAL DUE this Billing Period $ 367.00 <br /> PAYMENT <br /> RECEI\/Gn <br /> FEB 4 2008 <br /> SAN JOAOUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <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 OES/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 /> 1254 rpt <br />