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SAN JOAQUIN COUNTY <br /> EN'.',.RONMENTAL HEALTH DEPART& Page 1 <br /> 304-E WEI§ER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR 0017-34 T <br /> LMMMEMMMONNEM <br /> Facility ID F FA0010341 <br /> LENNOWMINMOMMA <br /> Date Printed 1/30/2006 <br /> INEEMENEEMENUMMA <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# IN0143006---Date of Invoice: 1127/2006 11111111111111111111 IN IIIIII IIIII IN IN <br /> 1/27/2006 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 270.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> [ Total for this Invoice $ 49 --Oo <br /> Payment Due Date 3/112006 <br /> TOTAL DUE this Billing Period <br /> PAy-P'1G <br /> RCOE'VND <br /> FEB 2 3 2006 <br /> SAE OAOUh,,.OOUNTy <br /> HEALTH pF MENTAL <br /> PARTAIENT <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 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 />