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SAN --OAQUIN COUNTY <br /> --NVIRQNMENTAL HEALTH DEPARTM--'— Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> <br /> <br /> Facility ID FA0014761 <br /> Date Printed 2 <br /> SCOTT M LAWRENCE RE : BODYCRAFT AUTO BODY & PAINT <br /> BODYCRAFT AUTO BODY & PAINT 17285 N BRUELLA RD <br /> 11318 FRANKLIN BLVD VICTOR, CA 95253 <br /> ELK GROVE, CA 95758 <br /> OWNER : LAWRENCE, SCOTT M <br /> Date Health <br /> Program Description _ Amount <br /> Invoice# IN0117540---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 224.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 224.00 <br /> to �- <br /> YOB <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 />