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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTT Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR If <br /> STOCKTON, CA 9520 <br /> <br /> lD AR0016146 <br /> Facility ID [ FA0009146 <br /> Date Printed 1/24/2005 111 <br /> MIRACLE AUTO PAINTING RE : MIRACLE AUTO PAINTING <br /> 1251 E BIANCHI RD 1251 E BIANCHI RD <br /> STOCKTON, CA 95210-3504 STOCKTON, CA 95210-3520 <br /> OWNER : KEVIN A STRAW <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0128969---Date of Invoice: 1/24/2005 I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII 11111 1111 IIII <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 255.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 479.00 <br /> Payment Due Date 2/23/2005 1 <br /> TOTAL DUE this Billing Period $ 479.00 J <br /> PAYMENT <br /> RECEIVED <br /> FEB 1 7 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 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 /> 5255.rpt <br />