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SAN JOAQUIN COUNTY <br /> Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM--'T <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0016959 <br /> Facility ID FA0009959 <br /> Date Printed 2/26/2010 ■ <br /> JUANS AUTO REPAIR RE : JUANS AUTO REPAIR <br /> 2843 SILVA ST 1145 S AURORA ST <br /> STOCKTON, CA 95205 STOCKTON, CA 95206 <br /> OWNER : JUAN O MORGA <br /> Date Health <br /> Program Descrintinn Amount <br /> I <br /> Invoice# IN0197947---Date of Invoice: 2/2/2010 IIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIII�IIII II'llllllllllllllllllll <br /> 2/1/2010 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 285.00 <br /> 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> Total for this Invoice $ 547.00 <br /> Payment Due Date 3/4/2010 <br /> TOTAL DUE this Billing Period $ 547.00 <br /> 4 <br /> PAYMENT <br /> RECEIVED <br /> MAR 0 3 2010 <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 />