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SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEP. MENT <br /> e <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> Phone: 209-468-3420 <br /> INVOICE AccountlD AR0003320 <br /> Facility ID FA0003741 <br /> Date Printed 3/1/2002 <br /> BROADBASE INC RE : JIFFY LUBE* <br /> JIFFY LUBE* 1130 N MAIN ST <br /> 3990 W YOSEMITE RD MANTECA CA 95336 <br /> LATHROP CA 95330 <br /> OWNER: CORRELL PROPERTIES/DON FOWLE <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0090709---Date of Invoice: 1/22/2002 <br /> 1/22/2002 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $17.50 <br /> 1/22/2002 2220 SM HW GEN<5 TONS/YR $200.00 <br /> Total for this Invoice $217.50 <br /> Payment Due Date 3171=2 <br /> TOTAL DUE this Billing Period $217.50\ <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 all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> Y1V _ <br /> 4�G'EI�NT <br /> 5255.rpt <br />