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CPG N TO: ICE OF REVENUE AND RECOVERY <br /> W ACCOUNT TRANSMITTAL • <br /> ACCOUNT NO. DEPT.NO. REFERRAL <br /> 026000.0 4/15/02 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> GOLDEN GATE ORN IRON WORKS <br /> C/O NAME GUARANTOR <br /> JESUS VALENZUELA <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 2489 E MINER AVE STOCKTON CA 95205 209-941-4090 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 209-941-4090 <br /> USER REFERENCE NO. BILL STA CYCLE STATUS DATE BM (,BMG INT MONTHLY PAY AMT P <br /> 6139 HAZMAT 1/14/02 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NOMARRATIVE <br /> SERVICE DATE: DATE OF O • <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NO <br /> 230 026000.0 2000 Hmmp Annual Fee $240.00 Business Owners: <br /> 3 Chems @ $15.00 Each $45.00 esus anue a <br /> 10% Late Fee $28.50 I I I I I 24-hour = 983-8730 <br /> 2001 Hmmp Annual Fee $240.00 <br /> 3 Chems @ $15.00 Each $45.00 5/14/99, 5/15/98, <br /> 10% Late Fee $28.50 6/5/95, 5/23/94 & <br /> \ F TOTAL $627.00 <br /> GUA <br /> DOB DR LIC NO AUTO LIC NO <br /> f. <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> GOLDEN GATE ORN IRON WORKS 209-941-4090 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 2489E MINER AVE STOCKTON CA 95205 <br /> Sp()US-E CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> VALEN7-UELA MANUELA <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> GOLDEN GATE ORN IRON WORKS 209-941-4090 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 2489E MINER AVE STOCKTON CA 95205 <br /> PREPAR BY / . . � C Y DATE 4/15/02 <br /> - COL. 20 (Y88' <br /> J <br />