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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM— Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0016959 <br /> Facility ID FA0009959 <br /> Date Printed 1/30/2006 <br /> JUAN'S AUTO REPAIR RE : JUAN'S AUTO REPAIR <br /> 1145 S AURORA ST 1145 S AURORA ST <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 <br /> OWNER : JUAN O MORGA <br /> Date Health <br /> Program Description Amount <br /> Invoice# I N0142884---Date of Invoice: 1/27/2006 11111 11111 11111 IN 111111 11111 IN IN <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 300.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 524.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ '524.00 / <br /> PAYMENIT <br /> RECEIVED <br /> MAR .. 1 2006 <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 /> 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 /> 5254.rpt <br />