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CI\Y If\VI\IY,LI\I f\L I,Lf\L vL, n,• � L �' <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (208)468J420 <br /> INVOICEAccount ID AR0035527 <br /> Fadfity ID FA0019948 <br /> DatePnntea 11/30/2009 <br /> PAYLESS SMOG RE : PAYLESS SMOG <br /> 3227 E MAIN ST A 3227 E MAIN ST A <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : MARIA SERRATO <br /> Date Health Amount <br /> Program Description p <br /> Invoice# IN0193902—Date of Invoice: 9124/2009 I'IIIIIII�IIIIIIIIi�VIII IIIIIIIIIII'II VIII�III IIIIIIIIIIIIIIII�I VIII IIII IIII <br /> 9/24/2009 2244 2009 HAZMAT FEE PLUS 3 YEARS BACK BILLING $ 340.00 <br /> 11/15/2009 9987 Haz Mat Program Penalty Fee $ 34.00 <br /> Total for thla Invoice $ 374.00 <br /> Payment Due Date 10/2412009 <br /> TOTAL DUE this Billing Period $ 374.00 <br /> DUE <br /> Delinquent chargee <br /> Ml be forwarded to <br /> 0OLLECTIONS <br /> it 3D da..1r5. <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 />