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aHty JUAWIJIN t UUN 1 r <br /> ENVIROWENTAL HEALTH DEPARTME . Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE �{ Account ID AR0016079 <br /> I Facility ID FA0009079 <br /> Date Printed 5!28/2008 <br /> ABC RADIATOR RE : ABC RADIATOR <br /> 601 S WILSON WAY 601 S WILSON WAY <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : EDWARD F FORTUNE <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice tit IN0170057--Date of invoice: 1/25/2008 I VIII VIII IIIIIIIIIIIIIIII IIII VIII VI IIIIIIIII VIIIIIIIIII IIIIIIIIIIIIIII <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 Penalty 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 Bil_fin_g_P_e_rio­dk $ 813.00 <br /> W <br /> Delinquent CnargeS <br /> will be tOrWardE d t0 <br /> COLLECTIONS <br /> jr 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 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 />