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ENVIRONMENTAL HEALTH DEPARTM yV <br /> 1868 E HAZFLTON AVENUE . RECE1V(` . • <br /> STOtKTON, CA 95205 D <br /> INVOICE JUL 182012Amount ID AR002 0024 <br /> LEMEMEMONOMMMEB <br /> EN �RpNMENT Facility ID FA0014717 <br /> EPgRTMEN�L <br /> Date Printed F 6/27/2012 <br /> LEENNNOMEMEMMMMA <br /> EASTSIDE AUTO REPAIR RE : EASTSIDE AUTO REPAIR <br /> <br /> CER : EDMUNDO <br /> A 95215 <br /> OW AYALA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0224737--Date of Invoice: 1/30/2012 //�� I IIIIIIII II IIIVIIIIIIIIIIIIIVIIIVIIIVIIIVIIIIII II II IIIIIIIII VIIIIIIIIIII <br /> 1/27/2012 2220 SM HW GEN<5 TONSNI / $ 213.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 85.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM F STATE SURCHARGE F $ 24.00 <br /> 1/27/2012 ERSC ELECTRONIC RE TING STATE SUMHRE $ 25.00 <br /> 3/15/2012 9987 Haz Mat Pro Penalty Fee $ 8.50 <br /> 4/15/2012 9994 PERMIT E PENALTY j/ $ 213.00 <br /> Total for this Invoice § 588.60 <br /> PAST DUE <br /> �'�A,''ry✓"" �'j� TOTAL DUE this Billing Periodl $ 568.50 <br /> X73 - 05 "'b Di E! <br /> 20 /5 yYEWOYOUR <br /> pAYN11 N TODAY:qr <br /> 'A �� °prI��� L 7 ) <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 Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />