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aruv JUM%JUuv �UUIv I r Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME"T <br /> 600 E MAIN STREET 1,11,.. ../ <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 // <br /> INVOICE N Account ID <br /> AR0016508 <br /> �� I Facility ID F FA0009508 <br /> LIMEMMMONOWAMMMI <br /> Date Printed 5/28/2008 <br /> LEWMNMNNENMNENNA <br /> BONNIE L BERNEISER RE : GUARANTEE REPAIR SERVICE <br /> GUARANTEE REPAIR SERVICE 101 COMMERCE ST <br /> PO BOX 246 LODI, CA 95240 <br /> VICTOR, CA 95253-0246 <br /> OWNER : BONNIE BERNEISER <br /> Dafe Health <br /> Program Description Amount <br /> Invoice# IN0170234--•Date of Invoice: 1125/2008 IIIIIIIIIIIIII III VIII ILII VIII IIID VIII VIII IIIIIII VIII IIII IIIIII VIII IIII IIII <br /> 1/25/2008 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 300.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2008 9987 Haz Mat Program Penalty Fee $ 30.00 <br /> 4/15/2008 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this Invoice $ 780.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 780.00 <br /> Doi <br /> r linquent Charges <br /> Wiii be, $nrlNardCd to <br /> C,0 LLECTIl <br /> in 3n days, <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 DES/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 />