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SANJOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTME' Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR _ <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD RR0024504 <br /> Facility ID F FA0014424 <br /> Date Printed F 2/27/2004 <br /> TRACY VW RE : TRACY VW <br /> 2605 AUTO PLAZA DR 2605 AUTO PLAZA DR <br /> TRACY, CA 95376 TRACY, CA 95376 <br /> OWNER : ISSAC SERGIS <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0116572-•-Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 130.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this lnvolce $ 354.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ /354.00 <br /> i. <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 7 2004 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <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 /> 5255.rpt <br />