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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART6 —'IT Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> 00 442 55 <br /> Facility ID F FA0014262 <br /> LEEMMMMOMOMEM <br /> Date Printed 1/24/2005 <br /> END OF THE LINE AUTO REPAIR RE : END OF THE LINE AUTO REPAIR <br /> 200 COMMERCE ST#101 200 COMMERCE ST#101 <br /> LODI, CA 95240-0841 LODI, CA 95240 <br /> OWNER : POTEET, MIKE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0128811 --Date of Invoice: 112412005 IIIIIIIIIIIIVIIIVIIIIIIIIIIVIIIIIIIIIIVIIIVIIIIIIII VIIIIIII IN <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 315.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 539.00 <br /> Payment Due Date 2/2312005 <br /> TOTAL DUE this Billing Period $ 539.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 2 2005 <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 DES/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 /> 5255.rpt <br />