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tNVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 304 E WEBER AVE -3RD FLOOR REF(- -z1 ne j) <br /> STOCKTON, CA 95202 11 <br /> Phone: (209)468-3420 APR 2 8 2004 <br /> INVOICE AR0024993 <br /> 10. <br /> _ G�)PSCn/ Account ID <br /> 00 <br /> Facility ID FA0014686 <br /> Date Printed 4/26/2004 <br /> CENTURY AUTO COLLISION RE : CENTURY AUTO COLLISION <br /> 3128 E FREMONT ST 3128 E FREMONT ST <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : NORMA CORTES <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0117488—Date of Invoice: 2/4/2004 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 255.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> 3/21/2004 9987 Haz Mal Program Penalty Fee $ 25.50 <br /> Total for this Invoice $ 304.50 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 304.50 <br /> PAST Cly ! <br /> WE WOULD APPRECIATE YOUR <br /> PAYNirNT TODAY! <br /> PAST 'DUE. <br /> Delinquent charges <br /> Will be forwarded to <br /> COLLECTION" <br /> in 30 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 /> 5255.rpt <br />