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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTIV - <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICEAccount ID AR0004379 <br /> Facility ID FA0002387 <br /> Date Printed 2/5/2004 <br /> KEYSTONE AUTMOTIVE INDUSTRIES INC RE : KEYSTONE AUTOMOTIVE INDUSTRIES INC <br /> 632 S EL DORADST 632 S EL DORADO ST <br /> STOCKTON, CA 95203-3407 STOCKTON, CA 95203 <br /> OWNER : KEYSTONE AUTOMOTIVE IND INC <br /> Health Amount <br /> vase Program Descripti n <br /> Invoice# IN0116081 ---Date of Invoice 2/412004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS'YR $ 200.00 <br /> $ 300.00 <br /> 2/4/2004 2244 2004 H MAT FE. <br /> 2/4/2004 2399 UNIFIEDPROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 524.00 <br /> Payment Due Date 3/6/200 <br /> TOTAL DUE this Billing Period $ 524.00 <br /> pAYNAENT <br /> RECEIVED <br /> FEB 2 1 2004 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPART MLNT <br /> Please make Checks PAYABLE to: 'EHD' — Retum 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 Fe 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 /> >2».rpt <br />