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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM- Page 1 <br /> 304 E ViIEBER AVE -3RD FLOOR <br /> STQCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD aRoo,so,2 <br /> Facility ID F FA0009 112 <br /> Date Printed 2/5/2004 <br /> Inamommoommomom <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# IN0115478---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 85.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoicel $ 309.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ :'309.00 <br /> PAYM E N ; <br /> RECEIVED <br /> MAR 8 2004 <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 there, <br /> 5255.rpt <br />