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tNVIKUNMtNIAL HEALIN DEPAKIMtN1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Acmunl ID r AR0024993 <br /> Faculty ID f FA0014686 <br /> Duln Ninlod 8/25/2003 <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 /> Dale Health <br /> Program Description <br /> Amount <br /> Invoice# IN0108739---Dale of Invoice: 5/23/2003 <br /> 5/23/2003 2244 2003 HAZMAT FEE PLUS 4 YEARS BACK BILLING $ 1,275.00 <br /> 5/23/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> 7/15/2003 9987 Haz Mat Program Penalty Fee $ 127.50 <br /> Total for this Invoice $ 1,420.00 <br /> Payment Due Date 6/26/2003 <br /> TOTAL DUE this Billing Period $ 1,420.00 <br /> WE WOULD d\S'i f;l.t;IfeTEYOUF'< <br /> taryt,pl iz5 1{?i! W <br /> „ <br /> IPI 11 <br /> i:,'ll: P, h ., <br /> its ,,. ' i�`'v , <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 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 Dale 60 Days after the Invoice Dale and each 30 Days thereafter <br /> 525Sipl <br />