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SAN dUAWUIN WUN1Y <br /> ENVIRONMENTAL HEALTH DEPARTMENT REIVED Page 1 <br /> 600 E MAIN STREET <br /> $TOCKTON, CA 95202 <br /> Phone: (209)468-3420 APR 2 0 2009 <br /> INVOICE <br /> SAN JOAQUIN COUNTY Account ID AR0016390 <br /> OFFICE OF EMERGENCY SERVICES <br /> i <br /> 'I CX Facility ID FA0009390 <br /> ' U U Date Printed 3/25/2009 <br /> R&B AUTO REPAIR RE : R&B AUTO REPAIR <br /> 1108 LAKEWOOD AVE 1211 S TURNPIKE RD <br /> MODESTO, CA 95355 STOCKTON, CA 95206 <br /> OWNER : ROARK, JERRY D <br /> Dale Health <br /> Program Description Amount <br /> Involce# IN0180914--Date of Invoice: 10/232008 IIIIIIII IIIIII IIIIIIIIIIIIIIIIIIIIIII 1111111111111111111 IN <br /> 10/23/2008 2244 2008 HAZMAT FEE $85.00 <br /> 12/152008 9987 Haz Mal Program Penalty Fee $8.50 <br /> 1/5/2009 9999 PAYMENT ($85.00) <br /> Total for this Invoice $8.50 <br /> PAST DUE <br /> Invoice# IN0183904--Date of Invoice: 1/29/2009 I IIIIIII III II IIIIIIIIIIIIIV II IIIIIIIIII VIII VIII VIIIIIIIIIIII I IIII IIIIIIIIIIIII <br /> 1/29/2009 2244 2009 HAZMAT FEE $85.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $24.00 <br /> 3/15/2009 9987 Haz Mat Program Penalty Fee $8.50 <br /> Total for this invoice $117.50 <br /> Payment Due Date 2/28/2009 <br /> TOTAL DUE this Billing Period $ 126.00 <br /> PAST DUE <br /> Delinquent charges <br /> will be forwarded to <br /> COLLECTIONS <br /> in 30 days. <br /> Please make Checks PAYABLE to: 'END' — 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 />