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bANJUAUUIN COUNTY <br /> = ENVff ONMENTAL HEALTH DEPARTP� 'VT Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> 4 <br /> INVOICE "` <br /> 0�C E � � � Account lD ARQ033302 <br /> REGEIVEoility lD FAD018757 <br /> IPPR 2.3 Mte Printed 3/26/20Q8 <br /> MOONLIGHT AUTORE : M OENaF L �Mpy � <br /> 2560 S ELDORADO ST 2560 S EL DORADO ST <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 <br /> OWNER : JOSE ROMERO <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0173276--Date of Invoice: 1/25/2008 Illlllllllllllllillf111111111111lfII1lfIfI[fill 1111101Hill 11111111111111111111111 <br /> 1/25/2008 2244 2008 HAZMAT FEE PLUS 2 YEARS BACK BILLING $ 255.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2008 9987 Haz Mat Program Penalty Fee $ 25.50 <br /> Total for this Invoice $ 304.50 <br /> Payment Due Date 2/2712008 <br /> TOTAL.DUE this Billing Period $ 304.50 <br /> JI <br /> I <br /> �. <br /> . _ <br /> Delinquent changes <br /> vvift be fOrwarded to <br /> �0LL f <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 I 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 />