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CI\\11\VI\MLI\I11L1 LIII VL � � � � �• <br /> 600 E MAIN STREET~ • <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE y Account ID AR0033439 <br /> hi' I LII Facility ID FA0018822 <br /> �f l Date Printed F 11/30/2009 <br /> LUIS A LOPEZ RE : TACOS Y MARISCOS SINALOA <br /> TACOS Y MARISCOS SINALOA 4127 WEST LN <br /> 2373 E SONORA ST STOCKTON, CA 95204 <br /> STOCKTON, CA 95205 <br /> OWNER : LOPEZ, LUIS ALBERTO <br /> Dale Health <br /> Program Description Amount <br /> Invoice# IN0193996—Date of Invoice: 9/2412009 llllllllnlllllllllllllllillVIIIIIIIVIIIIIIillllullllNIIIIIIIIIINIIII <br /> 9/24/2009 2244 2009 HAZMAT FEE $ 255.00 <br /> 11/15/2009 9987 Haz Mat Program Penalty Fee $ 25.50 <br /> Total for this Invoice $ 280.50 <br /> Payment Due Data 10/24/2009 <br /> TOTAL DUE this Billing Period $ 280.50 <br /> UE <br /> Delinquent charges <br /> will be forVyaI L ec—l' t® <br /> : .. <br /> in 30 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 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 />