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SAN JOAQUIN COUNTY <br /> ENVIROivMEN-i AL HEALTH DEPARTN' IT Page 1 <br /> 600 E MAIN STREET ` <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID <br /> AR0003320 <br /> Facility ID FA0003741 <br /> Date Printed I 2/7/200$ <br /> BROADBASE INC RE : JIFFY LUBE #598 <br /> JIFFY LUBE#598 1130 N MAIN ST <br /> 1471 SHORE ST MANTECA, CA 95336 <br /> WEST SACRAMENTO, CA 95691-3512 <br /> OWNER : FOWLER, DON W <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0170329---Date of Invoice : 1/25/2008 1111111111$E 11111 11111�1111 11111 1111 11111 11111 11111 E111 1111 111111 11111 1111 IN <br /> 1/25/2008 2220 SM HW GEN <5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 315.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 552.00 <br /> Payment Due Date 2/27/2008 <br /> TOTAL DUE this Billing Period $ 552.00 <br /> RE TO <br /> N�OPOO�MEt�M�N� <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 />