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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM' x Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 D <br /> Phone: (209) 468-3420 <br /> INVOICE LEBMO773207 AccountID AR0017341 <br /> Li Facility ID FA00103-4 1 <br /> Date Printed 1/26/2007 <br /> KRAGEN AUTO PARTS#1144 RE : KRAGEN AUTO PARTS#1144 <br /> <br /> STOCKTON, CA 95207 <br /> OWNER : CKS AUTO INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0156854--Date ofInvoice: 1/25/2007 111111111111111111111 IN IIIII IIIII IIIII IIIII 111111111111111 IN IIIIII IIIII IIII IIII <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 270.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Involcel $ 500.00 <br /> Payment Due Date 2/25 <br /> TOTAL DUE this Billing Period $ 500.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 0 2007 <br /> SAN JOAQUIN COUNTY <br /> HEAENLTH 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 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 /> 5254.rpt <br />