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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPART. T <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0020959 <br /> Facility ID FA0012658 <br /> Date Printed 2/27/2003 <br /> MARTINEZ, GEO GE RE : BACK ROADS CUSTOM CYCLE <br /> BACK ROADS C STOM CYCLE 7939 W 11TH ST <br /> 7939A E 11TH S TRACY, CA 95304 <br /> TRACY, A 9530 <br /> OWNER : MARTINEZ, GEORGE <br /> Date Health <br /> Proomm Descripti n Amount <br /> Invoice# IN0104018—Date of Invoice 2/27/2003 <br /> 2/27/2003 2220 SM HW EN<5 TONS/YR $ 200.00 <br /> 2/27/2003 2399 UNIFIE PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Invoice $ 217.50 <br /> Payment Due Date 3/29/2003 <br /> TOTAL DUE this Billing Period $ ,! 217.50 <br /> PAyMEN_V <br /> RECoVED <br /> APR 6 2003 <br /> GOONTY <br /> SAN Jva�`Ty S RVICES <br /> PUBLIC H Te t1 A TH DIVISION <br /> EN�.';RO;;iJltld, t <br /> Please make Chec k1s <br /> PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be adde to all Permit Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after t e Due Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5255.rpt <br />