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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPAjRTMF"T Page 1 <br /> a <br /> 304 E WEBER AVE -3RD FLOOR <br /> <br /> <br /> <br /> acility ID FA0009449 <br /> Date Printed 1/30/2006 <br /> BOULEVARD AUTOMOTIVE SVC RE : BOULEVARD AUTOMOTIVE SVC <br /> 2151 W COUNTRY CLUB BLVD 2151 W COUNTRY CLUB BLVD <br /> STOCKTON, CA 5204-4801 STOCKTON, CA 95204 <br /> OWNER : JOHN PARKER, RAY HUEY JR <br /> Date Health <br /> Program Descriptic n Amount <br /> Invoice# IN0142710---Date of Invoice: 1/27/2006 1111111 111111 111 11111 11E 11111 11111 11111 11111 11111 11111 11111 1111 111111 11111 IN IN <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 330.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 554.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 554.00 <br /> HA yA -11 <br /> pcb6 f- <br /> N2 V <br /> `SAN JOAQUI fu <br /> HEALTH�E aRT��n11 <br /> N7 <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 />