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JAN JUAI.IUIN WUN I Y <br /> ENVIRONMENTAL HEALTH DEPARTMF"T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKPhone: ON,209 46 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0016012 <br /> Facility ID FA0009012 <br /> Date Printed 1/30/2006 <br /> PAYLESS AUTO REPAIR INC RE : PAYLESS AUTO REPAIR INC <br /> <br /> LODI, CA 95240 <br /> OWNER : PAYLESS AUTO REPAIR INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0142527—Date of Invoice: 112712006 1IIIIIIIIIIIIIIVIIVIIIIIIDVIIIVIIVIII VIIIVIII VIII IIII 111111111111111 IIII <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 85.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 309.00 <br /> Payment Due Date 311/20 <br /> TOTAL DUE this Billintj <br /> g Period $ 309. <br /> PA�(tv'Ir <br /> boo FE6 0 6 200b <br /> GCS" SAN JOAOUIN('OUNTY <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 CES I 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 />