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JAN JVAWUIN UUUN I T Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMW . <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE �i 11 Account ID AR0016839 <br /> V Facility ID FA0009839 <br /> LMMMMMMMMMA <br /> Date Printed 5/28/2008 <br /> Lammoommoommmumm <br /> WEST LANE RADIATOR RE : WEST LANE RADIATOR <br /> 3941 N WEST LN 3941 N WEST LN <br /> STOCKTON, CA 95204 STOCKTON, CA 95204 <br /> OWNER : FORTUNE & FORTUNE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0170336--Date of Invoice : 1125/2006 1111111 111111 III VIII 11111 11111 VIII 11111 VIII VIII VIII IIT 1111111111 VIII 11111111 <br /> 1/25/2008 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 330.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2008 9987 Haz Mat Program Penafty Fee $ 33.00 <br /> 4/15/2008 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this Invoice $ 813.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 613.00 <br /> UE <br /> Deliriquent charge- <br /> ,witj die f , <br /> COLLECTIO NS <br /> in 3® days- <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 />