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OAN JUAUlUIN t.UUI1 I i Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMV • <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE t AccountlD AR0017109 <br /> Facility l0 F FA0010109 <br /> LMMMMMMNZRMWA <br /> V Date Printed F 5/28/2008 <br /> RAMIREZ AUTOMOTIVE RE : RAMIREZ AUTOMOTIVE <br /> 811 N SACRAMENTO ST 811 N SACRAMENTO ST <br /> LODI, CA 95240 LODI, CA 95240 <br /> OWNER : JUAN RAMIREZ JR <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0170415--Date of Invoice: 1/25/2008 I IIIIII II I I V II VIII VI II III VII I III III I V II IIII VIII VIII IIII IN <br /> 1/25/2008 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 285.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2008 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> 4/15/2008 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this Invoice $ 763.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 763.50 <br /> ` U <br /> elinquen't e iargec- <br /> §!4 P aomefdJ0�$ 10 <br /> tc'PLwn„ rho� <br /> in 3® dRys- <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/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 />